Provider Demographics
NPI:1447283775
Name:BANKS, AARON ELIJAH (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:ELIJAH
Last Name:BANKS
Suffix:
Gender:M
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:PO BOX 6489
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-0489
Mailing Address - Country:US
Mailing Address - Phone:877-664-0808
Mailing Address - Fax:
Practice Address - Street 1:500 OLD RIVER RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9504
Practice Address - Country:US
Practice Address - Phone:877-664-0808
Practice Address - Fax:800-691-2492
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA831692080P0202X
NMMD2023-12552080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology