Provider Demographics
NPI:1790098341
Name:ARELLANO BANONI, GISELA (MD)
Entity Type:Individual
Prefix:DR
First Name:GISELA
Middle Name:
Last Name:ARELLANO BANONI
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 1:1721 N NAPA DR
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-9137
Mailing Address - Country:US
Mailing Address - Phone:650-208-4123
Mailing Address - Fax:
Practice Address - Street 1:1209 WHITLEY AVE
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-2327
Practice Address - Country:US
Practice Address - Phone:559-992-5020
Practice Address - Fax:559-992-3997
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127294207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFA4228791OtherDEA