Provider Demographics
NPI:1578753141
Name:BANIPALSIN, SARKIS (MD)
Entity Type:Individual
Prefix:
First Name:SARKIS
Middle Name:
Last Name:BANIPALSIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 WESTWOOD DR STE 5
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5110
Mailing Address - Country:US
Mailing Address - Phone:408-448-2264
Mailing Address - Fax:408-266-2264
Practice Address - Street 1:1610 WESTWOOD DR STE 5
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5110
Practice Address - Country:US
Practice Address - Phone:408-448-2264
Practice Address - Fax:408-266-2264
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA102655207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA102655OtherMEDICAL BOARD OF CA
IL036118994Other036118994