Clinica Western

LBN: Dante A. Banta, M.D., Inc.
Clinica Western is an health care organization with primary practice located at 875 N Western Ave , Los Angeles CA 90029-3759. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Dante A. Banta, M.D., Inc. can be contacted via phone (323) 461-0777, or through Banta, Dante Atienza via phone (323) 461-0777.

Contact Information

Primary practice address
875 N Western Ave Los Angeles CA 90029-3759
Phone: (323) 461-0777
Fax: (323) 461-8035
Website:
Map and Directions
Authorized official contact:
Name: Banta, Dante Atienza Doctor of Medicine (MD)
Phone: (323) 461-0777

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X A44079 California

Profile Details

NPI number 1215100417
LBN Legal business name Dante A. Banta, M.D., Inc.
DBA Doing business as Clinica Western
Authorized official Banta, Dante Atienza Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 8th, 2008
Last updated Aug 2nd, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215100417 NPPES
California MEDICAID 00A440791

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