Warren Banta MD, a Medical Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A88514 Issued in CA

Legal business name

WARREN BANTA MD, A MEDICAL CORPORATION

Practice address

875 N Western Ave
Los Angeles, CA 90029-3759

Phone

(323) 461-0777

NPI assigned

May 19, 2009

Organization subpart

No

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

Authorized official

Name

Warren Banta, MD

Title

President

Phone

(323) 229-9471

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1992930994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-461-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-461-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN BANTA MD, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "BANTA",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-229-9471",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A88514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Ann Warner, CPNP
• Tamequa Warner
• Timothy Allen Warner
• Danielle Warnke
• Robert Sean Warnock, ARNP
• Warren J. Gerosa, DDS,Inc.
• Donna Betty Warren-Kruer, RN
• Bradley Lander Warren, M.D.
• Christina Warren, R.N.
• Darryl Erwin Warren, RN

• Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; 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.