Individual
KASTURI BANERJEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
100 MEDICAL PLAZA, SUITE 205, LOS ANGELES, CA 90024
(310) 825-1597
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35184
CA
207RG0100X
Gastroenterology Physician
35184
CA
Other
Enumeration date
07/26/2024
Last updated
11/01/2024
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