Provider Demographics
NPI:1275563355
Name:BANKS, DALIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:DALIA
Middle Name:A
Last Name:BANKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 675954
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-5954
Mailing Address - Country:US
Mailing Address - Phone:858-792-0221
Mailing Address - Fax:
Practice Address - Street 1:UCSD MEDICAL CENTER
Practice Address - Street 2:200 WEST ARBOR DRIVE MC 0801
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:619-543-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83786207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A837860Medicaid
CAWA83786AMedicare ID - Type Unspecified
H44389Medicare UPIN
CA00A837860Medicaid