Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G017561 | CA |
NPI | 1336130988 |
---|---|
Provider Name | Dr. Daniel R Benson |
First Address | Sacramento, CA 95825-6504 |
Second Address | Sacramento, CA 95825-6504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 28/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G175610 | (05) | CA |
A40113 | (02) | CA |