Healthcare Provider Details

I. General information

NPI: 1407742323
Provider Name (Legal Business Name): RAMANPREET BENIPAL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4615 N 1ST ST
FRESNO CA
93726-0904
US

IV. Provider business mailing address

PO BOX 491
FAIRFIELD CA
94533-0049
US

V. Phone/Fax

Practice location:
  • Phone: 800-492-4227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: