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General NPI Number Information
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NPI Number | 1962604264
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Entity Type | Organization
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Legal Business Name | RONALD BANGSIL MD PC
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 11/24/2017
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Provider Practice Location Address
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Address Line | 408 S BEACH BLVD SUITE 111
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City | ANAHEIM
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State | CA
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Zip | 92804-1866
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Country | US
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Telephone | 714-226-0770
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Fax |
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Provider Business Mailing Address
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Address Line | 21 MARINER CV
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City | BUENA PARK
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State | CA
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Zip | 90621-1662
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Country | US
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Telephone | 714-226-0770
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Fax |
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Authorized Official
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Title or Position | CEO/MEDICAL DIRECTOR
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Name | DR. RONALD BANGSIL
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Credential | MD
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Telephone | 714-226-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A66106
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License Number State | CA
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