Banuelos, Elias Ignacio

Banuelos, Elias Ignacio is an individual health care provider with primary practice located at 911 Washington St , Calistoga CA 94515-1433. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Banuelos, Elias Ignacio can be contacted via phone (707) 709-2308.

Contact Information

Primary practice address
911 Washington St Calistoga CA 94515-1433
Phone: (707) 709-2308
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME97139 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A72691 California

Profile Details

NPI number 1366427064
LBN Legal business name Banuelos, Elias Ignacio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Sep 29th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366427064 NPPES
California MEDICAID 00A726910

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