Benavidez, Michael Anthony

Benavidez, Michael Anthony is an individual health care provider with primary practice located at 984 W Foothill Blvd , Upland CA 91786-3700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Benavidez, Michael Anthony can be contacted via phone (909) 373-8222.

Contact Information

Primary practice address
984 W Foothill Blvd Upland CA 91786-3700
Phone: (909) 373-8222
Fax: (909) 373-8226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20A6396 California

Profile Details

NPI number 1205987914
LBN Legal business name Benavidez, Michael Anthony
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205987914 NPPES
California MEDICAID 00AX63960

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