DANTE A. BANTA, M.D., INC.


Address: 875 N Western Ave, Los Angeles, CA 90029-3759
Phone: 3234610777

DANTE A. BANTA, M.D., INC. (NPI# 1215100417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215100417
Entity Type Organization
Organization Name DANTE A. BANTA, M.D., INC.
Other Organization Name CLINICA WESTERN
Practice Address 875 N Western Ave
Los Angeles
CA 90029-3759
Practice Telephone 3234610777
Practice Fax Number 3234618035
Mailing Telephone 3234610777
Mailing Fax Number 3234618035
Enumeration Date 2008-04-08
Last Update Date 2011-08-02
Authorized Official Name DR. DANTE ATIENZA BANTA (PRESIDENT)
Authorized Official Telephone 3234610777
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
A44079 CA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA 00A440791 05

Other Provider/Organization Names

Other Name Type Code
Clinica Western Doing Business As Name - Organization

Office Location

Street Address 875 N WESTERN AVE
City LOS ANGELES
State CA
Zip Code 90029-3759

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912071085 Dante Atienza Banta Family Medicine 875 N Western Ave, Los Angeles, CA 90029-3759 2006-11-20
1548567480 Gonzalo Corzo, D.d.s. A Professional Corporation Dentist 875 N Western Ave, Los Angeles, CA 90029-3759 2011-02-11
1851605992 Veronica Morales Banta M.d., Inc. Clinic/Center 875 N Western Ave, Los Angeles, CA 90029-3759 2010-07-30
1992930994 Warren Banta Md, A Medical Corporation Clinic/Center 875 N Western Ave, Los Angeles, CA 90029-3759 2009-05-19
1740439264 Arturo V. Hernandez, D.d.s. Point of Service 875 N Western Ave, Los Angeles, CA 90029-3759 2008-09-09
1265692925 Veronica M Banta Family Medicine 875 N Western Ave, Los Angeles, CA 90029-3759 2008-06-16

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1679930572 Sukhwa Park Acupuncturist 4870 Santa Monica Blvd, Los Angeles, CA 90029 2016-01-22
1629326749 Jocelyn Anne Brown Midwife 1042 Sanborn Ave Apt 9, Los Angeles, CA 90029 2012-08-21
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1033321013 Zhirayr Jerry Khoshoryan Chiropractor 1233 Vermont Ave., Suite 1b, Los Angeles, CA 90029 2007-05-04
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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1376036178 Rolando S. Mercader M.d. Inc. Clinic/Center 201 S Alvarado St Ste 600, Los Angeles, CA 90057-2386 2018-06-07
1669909958 David Rekar Md, Inc Clinic/Center 866 N Vermont Ave Ste 3a, Los Angeles, CA 90029-3587 2017-05-17
1639604895 Family Health Clinic Inc. Clinic/Center 133 S Vermont Ave, Los Angeles, CA 90004-5904 2017-04-25
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Competitor

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City LOS ANGELES
Zip Code 90029

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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