Healthcare Provider Details

I. General information

NPI: 1770783896
Provider Name (Legal Business Name): DR. HANI ADIEP BENYAMIN-AJAIPI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12762 CHRISTY LN
LOS ALAMITOS CA
90720-4969
US

IV. Provider business mailing address

12762 CHRISTY LN
LOS ALAMITOS CA
90720-4969
US

V. Phone/Fax

Practice location:
  • Phone: 347-277-6268
  • Fax: 714-209-7364
Mailing address:
  • Phone: 347-277-6268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number237931
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA89899
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: