Healthcare Provider Details
I. General information
NPI: 1639978216
Provider Name (Legal Business Name): DBMD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
691 S HARVARD BLVD
LOS ANGELES CA
90005-2513
US
IV. Provider business mailing address
691 S HARVARD BLVD
LOS ANGELES CA
90005-2513
US
V. Phone/Fax
- Phone: 213-235-5388
- Fax: 475-313-1265
- Phone: 213-235-5388
- Fax: 475-313-1265
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0122X |
| Taxonomy | Plastic and Reconstructive Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DENNIS
BANG
Title or Position: OWNER/DIRECTOR
Credential: MD
Phone: 213-929-3828