Provider Demographics
NPI:1750521605
Name:DANIEL S. BANDARI, M.D. INC
Entity type:Organization
Organization Name:DANIEL S. BANDARI, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-706-5580
Mailing Address - Street 1:24012 CALLE DE LA PLATA STE 210
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7623
Mailing Address - Country:US
Mailing Address - Phone:949-706-5580
Mailing Address - Fax:949-706-5585
Practice Address - Street 1:24012 CALLE DE LA PLATA STE 210
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7623
Practice Address - Country:US
Practice Address - Phone:949-706-5580
Practice Address - Fax:949-706-5585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA843502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty