Individual provider · NPI-1

Augusto F Banayat, FNP

Nurse Practitioner · San Bernardino, CA

NPI number1831727700
StatusActive
Last updated in NPPESNov 14, 2025

Details

NPI
1831727700
Entity type
Individual (NPI-1)
Name
Augusto F Banayat
Credential
FNP
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 27, 2020
Certification date
Nov 14, 2025
Last updated
Nov 14, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse PractitionerNPF95013989CAYes

Practice location

1700 N Waterman Ave
San Bernardino, CA 92404-5115

Phone 909-883-8611

Mailing address

Po Box 35380
Las Vegas, NV 89133-5380

Phone 702-579-3203

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