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General NPI Number Information
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NPI Number | 1588246078
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Entity Type | Organization
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Legal Business Name | JOHN R. DEBANTO, MD, INC.
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Dates
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Enumeration Date | 04/23/2021
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Last Update Date | 04/23/2021
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Provider Practice Location Address
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Address Line | 435 ARDEN AVE STE 530
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City | GLENDALE
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State | CA
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Zip | 91203-1140
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Country | US
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Telephone | 818-659-7444
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Fax | 818-332-1234
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Provider Business Mailing Address
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Address Line | 435 ARDEN AVE STE 530
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City | GLENDALE
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State | CA
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Zip | 91203-1140
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Country | US
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Telephone | 818-659-7444
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Fax | 818-332-1234
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JOHN ROBERT DEBANTO
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Credential | MD
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Telephone | 818-659-7444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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