Bennet, Justin David
Bennet, Justin David is an individual health care provider with primary practice located at 1505 Soquel Dr Suite12, Santa Cruz CA 95065-1716. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Hepatology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Bennet, Justin David can be contacted via phone (831) 713-5050.Contact Information
Primary practice address
1505 Soquel Dr Suite12
Santa Cruz CA 95065-1716
Phone: (831) 713-5050
Fax: (831) 475-0101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 0101840379 | Virginia |
| Allopathic & Osteopathic Physicians / Hepatology | 207RI0008X | 0101840379 | Virginia |
Profile Details
| NPI number | 1134299308 |
|---|---|
| LBN Legal business name | Bennet, Justin David |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2006 |
| Last updated | Jun 15th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134299308 | NPPES |
| Virginia | MEDICAID | 005847958 |
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