DR. VIJAYA BANSAL M.D.
NPI 1174665756
Specialist in Stockton, CA

Active since February 12, 2007PECOS Enrolled
1617 N. CALIFORNIA ST., SUITE 2A, STOCKTON, CA 95204(209) 466-8546(209) 466-3335 Get Directions Write a Review

NPPES record last updated: April 15, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Vijaya Bansal M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. VIJAYA BANSAL M.D. (NPI 1174665756) is an individual specialist in Stockton, California, licensed in California (A69278) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174665756
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameDR. VIJAYA BANSALCredential: M.D.
Location Address1617 N. CALIFORNIA ST., SUITE 2AStockton, CA 95204
Mailing AddressP.o. Box 1090Lodi, CA 95241-1090 · (209) 334-1800 · Fax (209) 334-1430
Fax(209) 466-3335
Sole ProprietorNo
Enumeration DateFebruary 12, 2007
Last NPPES UpdateApril 15, 2009
NPI 1174665756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in CA · A69278
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License A69278 (CA)
Also ListedObstetrics & Gynecology · Maternal & Fetal MedicineTaxonomy 207VM0101X · License A69278 (CA)
1617 N. CALIFORNIA ST., Stockton, CA 95204

Other Identifiers 2

Medicare UPINF90307CA
Medicare PINZZZ14503ZCA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Vijaya Bansal M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174665756, enumerated as an "individual" on February 12, 2007.

The provider is located at 1617 N. CALIFORNIA ST. SUITE 2A STOCKTON, CA 95204 and the phone number is (209) 466-8546.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.