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Individual

ALYSSA ANNE BANTAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2300 BOSWELL RD STE 280, CHULA VISTA, CA 91914-3539
(619) 761-1574
Mailing address
621 EDGEWATER DR, SAN MARCOS, CA 92078-6001
(760) 975-9797

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
CA

Other

Enumeration date
02/03/2026
Last updated
02/04/2026
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