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General NPI Number Information
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NPI Number | 1295773422
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Entity Type | Individual
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Provider Name | SANJOY BANERJEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 2097 COMPTON AVE SUITE 102
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City | CORONA
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State | CA
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Zip | 92881-7282
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Country | US
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Telephone | 951-735-7246
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Fax | 951-268-9516
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Provider Business Mailing Address
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Address Line | 2097 COMPTON AVE SUITE 102
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City | CORONA
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State | CA
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Zip | 92881-7282
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Country | US
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Telephone | 951-735-7246
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Fax | 951-268-9516
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A90939
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License Number State | CA
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