Individual
MARY ANN BANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2186 GEARY BLVD STE 312, SAN FRANCISCO, CA 94115-3457
(415) 285-5180
Mailing address
2186 GEARY BLVD STE 312, SAN FRANCISCO, CA 94115-3457
(415) 285-5180
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G842181
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G842181
—
CA
01
—
G842181
STATE LICENSE
CA
Enumeration date
04/05/2006
Last updated
09/26/2018
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