CLINICA WESTERN
NPI 1215100417
Clinic/Center - Primary Care in Los Angeles, CA

Active since April 08, 2008CLIA 05D0903012 · Waiver
875 N WESTERN AVE, LOS ANGELES, CA 90029(323) 461-0777(323) 461-8035 Get Directions Write a Review

NPPES record last updated: August 2, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Clinica Western NPPES

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

CLINICA WESTERN (NPI 1215100417) is a healthcare organization registered as a primary care in Los Angeles, California and active in the NPI registry since April 2008. The organization holds a CLIA Waiver certificate valid through July 9, 2027 and lists Dante Atienza Banta, President, as its authorized official.

NPPES Registry Identity

NPI1215100417
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameDANTE A. BANTA, M.D., INC.
Location Address875 N WESTERN AVELos Angeles, CA 90029-3759
Mailing Address875 N Western AveLos Angeles, CA 90029-3759 · (323) 461-0777 · Fax (323) 461-8035
Fax(323) 461-8035
Organization SubpartNo
Authorized OfficialDante Atienza BantaPresident · (323) 461-0777
Enumeration DateApril 8, 2008
Last NPPES UpdateAugust 2, 2011
NPI 1215100417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in CA · A44079
875 N WESTERN AVE, Los Angeles, CA 90029

Other Names 1

Doing Business AsClinica Western

Other Identifiers 2

Medicare PINA44079CA
Medicaid00A440791CA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0903012

Clinica Western Family Medical Clinic · Los Angeles, CA
Active · expires Jul 9, 2027
CLIA Number05D0903012
Laboratory TypePhysician Office
Certificate Effective DateJuly 10, 2025
Certificate Expiration DateJuly 9, 2027
Laboratory DirectorDante A. Banta
Laboratory Phone(323) 461-0777
Laboratory LocationClinica Western Family Medical Clinic875 N Western Ave, Los Angeles, CA 90029
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
875 N WESTERN AVE
LOS ANGELES, CA 90029
Dentist (General Practice)
875 N WESTERN AVE
LOS ANGELES, CA 90029
Dentist
875 N WESTERN AVE
LOS ANGELES, CA 90029
Point of Service
875 N WESTERN AVE
LOS ANGELES, CA 90029
Dentist
875 N WESTERN AVE
LOS ANGELES, CA 90029
Clinic/Center
875 N WESTERN AVE
LOS ANGELES, CA 90029
Family Medicine
875 N WESTERN AVE
LOS ANGELES, CA 90029
Clinic/Center
875 N WESTERN AVE
LOS ANGELES, CA 90029

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dante A. Banta, M.D., Inc.'s NPI number?

The NPI number for Dante A. Banta, M.D., Inc. is 1215100417. It was assigned to this organization in the NPPES registry on April 8, 2008. The provider is doing business as Clinica Western.

Where is Dante A. Banta, M.D., Inc. located?

Dante A. Banta, M.D., Inc. is located at 875 N Western Ave, Los Angeles, CA 90029. The listed phone number is (323) 461-0777.

What is Dante A. Banta, M.D., Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Dante A. Banta, M.D., Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0903012) is associated with this NPI, valid through July 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dante A. Banta, M.D., Inc. was last updated on August 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.