Organization
VERONICA MORALES BANTA M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERONICA MORALES BANTA M.D. (CHIEF EXECUTIVE OFFICER/PRESIDENT)
(323) 461-0777
Entity
Organization
Contact information
Practice address
875 N WESTERN AVE, LOS ANGELES, CA 90029-3759
(323) 461-0777
(323) 461-8035
Mailing address
875 N WESTERN AVE, LOS ANGELES, CA 90029-3759
(323) 461-0777
(323) 461-8035
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A104447
CA
Other
Enumeration date
07/30/2010
Last updated
08/12/2010
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