| Dante A. Banta, M.d., Inc. | |
|
875 N Western Ave Los Angeles CA 90029-3759 | |
| (323) 461-0777 | |
| (323) 461-8035 |
| Full Name | Dante A. Banta, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 875 N Western Ave, Los Angeles, California |
| Authorized Official Name and Position | Dante Atienza Banta (PRESIDENT) |
| Authorized Official Contact | 3234610777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dante A. Banta, M.d., Inc. 875 N Western Ave Los Angeles CA 90029-3759 Ph: (323) 461-0777 | Dante A. Banta, M.d., Inc. 875 N Western Ave Los Angeles CA 90029-3759 Ph: (323) 461-0777 |
| NPI Number | 1215100417 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 08/02/2011 |
| Medicare PECOS PAC ID | 2466523097 |
|---|---|
| Medicare Enrollment ID | O20080625000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215100417 | NPI | - | NPPES |
| 00A440791 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A44079 (California) | Primary |
| Provider Name | Dante A Banta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912071085 PECOS PAC ID: 0749351377 Enrollment ID: I20080625000204 |
| Provider Name | Veronica Morales Banta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265692925 PECOS PAC ID: 8224340468 Enrollment ID: I20150701000829 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
Special Service For Groups, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5811 S San Pedro St, Los Angeles, CA 90011 Phone: 213-553-1800 | |
Altamed Health Services Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Citadel Dr, Ste 490, Los Angeles, CA 90040 Phone: 323-725-8751 Fax: 323-889-7399 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |
Apla Health & Wellness Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 S Kingsley Dr, Los Angeles, CA 90005 Phone: 213-201-1623 Fax: 213-201-1595 | |
Hyo Rang Lee Md Phd Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4465 Wilshire Blvd, Ste 303, Los Angeles, CA 90010 Phone: 213-254-7103 Fax: 714-220-2301 | |
Croft Living Home, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 458 N Croft Ave, Los Angeles, CA 90048 Phone: 323-655-5060 Fax: 323-651-1461 |