Individual
AGNES BAHNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18625 SHERMAN WAY, RESEDA, CA 91335-4148
(818) 342-8171
Mailing address
18625 SHERMAN WAY, RESEDA, CA 91335-4148
(818) 342-8171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A128840
CA
208D00000X
General Practice Physician
A128840
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2011
Last updated
12/08/2022
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