Individual
PAUL BANCHICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
(562) 503-3139
Mailing address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
(562) 503-3139
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
CA
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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