| Jagan N. Bansal, M.d., Inc. | |
|
443 S Soto St Los Angeles CA 90033-4315 | |
| (323) 263-6103 | |
| (323) 263-2004 |
| Full Name | Jagan N. Bansal, M.d., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 443 S Soto St, Los Angeles, California |
| Authorized Official Name and Position | Jagan Nath Bansal (CEO) |
| Authorized Official Contact | 3234781101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jagan N. Bansal, M.d., Inc. 5540 N Figueroa St Los Angeles CA 90042-4120 Ph: (323) 478-1101 | Jagan N. Bansal, M.d., Inc. 443 S Soto St Los Angeles CA 90033-4315 Ph: (323) 263-6103 |
| NPI Number | 1013099936 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 09/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013099936 | NPI | - | NPPES |
| GR0100470 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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