Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 51896 | CA |
NPI | 1003918756 |
---|---|
Provider Name | Dr. Aicha Benbrahim |
First Address | Marysville, CA 95901-4214 |
Second Address | Marysville, CA 95901-4214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 22/07/2019 |