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General NPI Number Information
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NPI Number | 1922242767
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Entity Type | Organization
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Legal Business Name | DEBORAH BANSKTER MD INC
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 2700 GRANT ST SUITE306
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City | CONCORD
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State | CA
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Zip | 94520-2266
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Country | US
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Telephone | 925-356-8990
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Fax | 925-356-8995
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Provider Business Mailing Address
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Address Line | 880 CHANNING CIR
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City | BENICIA
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State | CA
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Zip | 94510-3636
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Country | US
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Telephone | 707-748-0747
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Fax | 925-356-8995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBORAH ANN BANSKTER
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Credential | M.D.
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Telephone | 707-748-0747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G78855
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License Number State | CA
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