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General NPI Number Information
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NPI Number | 1568858033
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Entity Type | Individual
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Provider Name | DANESH BANSAL MD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2015
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | 450 STANYAN ST DEPT
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1019
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Country | US
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Telephone | 415-750-4916
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Fax | 415-683-5591
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Provider Business Mailing Address
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Address Line | 1801 W OLYMPIC BLVD # 1687
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City | PASADENA
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State | CA
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Zip | 91199-1687
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Country | US
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Telephone | 775-283-3315
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Fax | 775-852-6902
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2020012220
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A172931
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35.138560
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License Number State | OH
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