Healthcare Provider Details

I. General information

NPI: 1912821257
Provider Name (Legal Business Name): ERIC J BANSAL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 N FIGUEROA ST
LOS ANGELES CA
90042-4120
US

IV. Provider business mailing address

5540 N FIGUEROA ST
LOS ANGELES CA
90042-4120
US

V. Phone/Fax

Practice location:
  • Phone: 323-252-8876
  • Fax:
Mailing address:
  • Phone: 323-252-8876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC BANSAL
Title or Position: PRESIDENT
Credential: MD
Phone: 323-252-8876