Cresencia Deleon Banzuela, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A53873 Issued in CA

Practice address

260 E Ontario Ave
Suite 204
Corona, CA 92879-3514

Phone

(951) 272-6595

Fax

(951) 272-3872

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AGBJCD/Endpoint/AGBJCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cresencia D Banzuela M.D. Inc

  • Pediatrics Physician
  • Corona, CA
  • NPI 1033134770
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1083639710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6038",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928786038",
            "telephone_number": "951-272-6595",
            "fax_number": "951-272-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E ONTARIO AVE",
            "address_2": "SUITE 204",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793514",
            "telephone_number": "951-272-6595",
            "fax_number": "951-272-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANZUELA",
        "first_name": "CRESENCIA",
        "middle_name": "DELEON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A53873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A538730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lonnie Banks Jr., L.C.S.W.
• Tamica Banks
• William Banks Jr.
• Daphne Fajayan Bantigue, B.S., DPT
• Deisy Banuelos
• Marita Ybuan Banzuela, M.D.
• Rehana S. Baqai, M.D.
• Brian Barajas
• Nivia Barajas
• Taviana Barajas, PA-C

• Pediatrics Physician in Corona, CA
• Providers in Corona, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.