DANTE A. BANTA, M.D., INC. is a primary care clinic center in Los Angeles, CA. DANTE A. BANTA, M.D., INC. NPI is 1215100417. The provider is registered as an organization entity type.
The provider Is Doing Business As Clinica Western.
The provider's business location address is:
875 N WESTERN AVE
LOS ANGELES, CA
ZIP 90029-759
Phone: (323) 461-0777
Fax: (323) 461-8035
The provider's authorized official is Dante Atienza Banta .
The authorized official title is President and has the following contact phone number (323) 461-0777.
The CLIA number assigned to this NPI record is 05D0903012 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 4/8/2008 and was last updated on 8/2/2011.