Individual provider · NPI-1

Dr. Firas Bannout, M.D

· Loma Linda, CA

NPI number1073750014
StatusActive
Last updated in NPPESJan 8, 2014

Details

NPI
1073750014
Entity type
Individual (NPI-1)
Name
Dr. Firas Bannout
Credential
M.D
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 13, 2009
Last updated
Jan 8, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0600X A100375CAYes
204D00000X Neuromusculoskeletal Medicine & OMMA100375CA

Practice location

11370 Anderson St
Suite B-100
Loma Linda, CA 92354-3450

Phone 909-558-2880

Mailing address

11370 Anderson St
Suite B-100
Loma Linda, CA 92354-3450

Phone 909-558-2880

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