Healthcare Provider Details

I. General information

NPI: 1447283775
Provider Name (Legal Business Name): AARON ELIJAH BANKS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OLD RIVER RD SUITE 105
BAKERSFIELD CA
93311-9504
US

IV. Provider business mailing address

PO BOX 6489
TORRANCE CA
90504-0489
US

V. Phone/Fax

Practice location:
  • Phone: 877-664-0808
  • Fax: 800-691-2492
Mailing address:
  • Phone: 877-664-0808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberA83169
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD2023-1255
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: