Provider Demographics
NPI:1700092426
Name:BANSIL, NELSON H (DO)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:H
Last Name:BANSIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W STEWART DR STE 212
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3837
Mailing Address - Country:US
Mailing Address - Phone:714-543-8911
Mailing Address - Fax:
Practice Address - Street 1:1310 W STEWART DR STE 212
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3837
Practice Address - Country:US
Practice Address - Phone:714-543-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A101492080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine