Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G18349 | CA |
NPI | 1043328503 |
---|---|
Provider Name | Ronald T. Benz |
First Address | San Diego, CA 92121-6310 |
Second Address | San Diego, CA 92121-6310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2006 |
Last Update Date | 14/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G183490 | (05) | CA |
A40328 | (02) | CA |