Individual
RAY ALLEN BANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
644A PULLER PL, SAN CLEMENTE, CA 92672-2563
(760) 994-4747
Mailing address
644A PULLER PL, SAN CLEMENTE, CA 92672-2563
(760) 994-4747
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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