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General NPI Number Information
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NPI Number | 1427164029
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Entity Type | Organization
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Legal Business Name | M.L. BANIGO, M.D., INC.
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 2532 VIA OLIVERA
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City | PALOS VERDES ESTATES
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State | CA
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Zip | 90274-2808
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Country | US
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Telephone | 310-971-5553
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Fax | 310-377-2498
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Provider Business Mailing Address
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Address Line | 2532 VIA OLIVERA
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City | PALOS VERDES ESTATES
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State | CA
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Zip | 90274-2808
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Country | US
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Telephone | 310-971-5553
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Fax | 310-377-2498
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAY LOLO BANIGO
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Credential | M.D.
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Telephone | 310-971-5553
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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 | A66185
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License Number State | CA
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