Provider Demographics
NPI:1457546582
Name:BANGARU, BABU S (MD)
Entity Type:Individual
Prefix:DR
First Name:BABU
Middle Name:S
Last Name:BANGARU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9422 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5151
Mailing Address - Country:US
Mailing Address - Phone:718-592-7797
Mailing Address - Fax:718-685-2777
Practice Address - Street 1:11175 CAMPUS STREET
Practice Address - Street 2:COLEMAN PAVILION SUITE # A1120
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-9235
Practice Address - Country:US
Practice Address - Phone:909-558-4773
Practice Address - Fax:909-558-0479
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2020-12-18
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Provider Licenses
StateLicense IDTaxonomies
NY1282352080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology