Provider Demographics
NPI:1285271247
Name:SANDEEP KUMAR BANSIL MD INC
Entity type:Organization
Organization Name:SANDEEP KUMAR BANSIL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:BANSIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-923-1211
Mailing Address - Street 1:641 S PRIMROSE ST
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-9245
Mailing Address - Country:US
Mailing Address - Phone:562-923-1211
Mailing Address - Fax:
Practice Address - Street 1:641 S PRIMROSE ST
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-9245
Practice Address - Country:US
Practice Address - Phone:562-923-1211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty