Healthcare Provider Details

I. General information

NPI: 1356668065
Provider Name (Legal Business Name): NATASHA BANERJEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W. CARSON STREET
TORRANCE CA
90509
US

IV. Provider business mailing address

1000 W. CARSON STREET BOX-400
TORRANCE CA
90509
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA118784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: