Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 20A13135 | CA |
NPI | 1043571151 |
---|---|
Provider Name | Pritisheel Banga |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Santa Cruz, CA 95065-1724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 21/07/2017 |