Healthcare Provider Details

I. General information

NPI: 1922331834
Provider Name (Legal Business Name): RICHARD M BENOIT MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44241 15TH ST W SUITE 205
LANCASTER CA
93534-4037
US

IV. Provider business mailing address

1 S ORANGE GROVE BLVD UNIT 4
PASADENA CA
91105-1782
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-2229
  • Fax: 661-949-2210
Mailing address:
  • Phone: 661-949-2229
  • Fax: 661-949-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD M BENOIT
Title or Position: EXECUTIVE DIRECTOR
Credential: M.D.
Phone: 661-949-2229