Basic Information
| Provider Information | |||||||||
| NPI: | 1396884888 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BANKS | ||||||||
| FirstName: | NORMAN | ||||||||
| MiddleName: | LAMARR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | BROOKSIDE COMMUNITY HEALTH CENTER | ||||||||
| Address2: | 2023 VALE ROAD, SUITE 107 | ||||||||
| City: | SAN PABLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 948063834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102319800 | ||||||||
| FaxNumber: | 5104129867 | ||||||||
| Practice Location | |||||||||
| Address1: | BROOKSIDE COMMUNITY HEALTH CENTER | ||||||||
| Address2: | 2023 VALE ROAD, SUITE 107 | ||||||||
| City: | SAN PABLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 948063834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102319800 | ||||||||
| FaxNumber: | 5104129867 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 03/29/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A53325 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.