MEDICARE: RAGHUNATH BANSAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A86883	CA

General Provider Information

NPI Number	:	1255445086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAGHUNATH BANSAL M.D.

Provider Business Mailing Address
First Line	:	1350 TREAT BLVD
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94597-2133
Country	:	US
Telephone Number	:	925-289-9022
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 OAK RD STE 270
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94597-2078
Country	:	US
Telephone Number	:	925-944-9711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	04/23/2020

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