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Individual

DR. AGI E BAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
615 ADDISON ST, BERKELEY, CA 94710-1919
(510) 845-4540
(510) 848-6569
Mailing address
615 ADDISON ST, BERKELEY, CA 94710-1919
(510) 845-4540
(510) 848-6569

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
21225
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DC21225
CHIROPRACTIC LICENSE
CA
Enumeration date
06/01/2007
Last updated
10/24/2016
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