Provider Demographics
NPI:1528850617
Name:BANZON MEDICAL INC
Entity type:Organization
Organization Name:BANZON MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE PAULO LUIGI
Authorized Official - Middle Name:AZARRAGA
Authorized Official - Last Name:BANZON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-894-1300
Mailing Address - Street 1:936 BURTON ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-4782
Mailing Address - Country:US
Mailing Address - Phone:619-894-1300
Mailing Address - Fax:
Practice Address - Street 1:HOPE MEDICAL ARTS PLAZA 29798 ROAD
Practice Address - Street 2:SUITE #106
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586
Practice Address - Country:US
Practice Address - Phone:951-301-3588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty