Organization
RAINER G. BANSUAN MD INC
Active
Other names
BANSUAN MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
RAINER G BANSUAN M.D. (MEDICAL DIRECTOR)
(626) 455-0982
Entity
Organization
Contact information
Practice address
10305 GARVEY AVE, EL MONTE, CA 91733-2135
(626) 455-0982
(626) 455-0984
Mailing address
10305 GARVEY AVE, EL MONTE, CA 91733-2135
(626) 455-0982
(626) 455-0984
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A51021
CA
261QA0005X
Ambulatory Family Planning Facility
A51021
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A51021
—
CA
Enumeration date
08/02/2011
Last updated
08/02/2011
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