Healthcare Provider Details

I. General information

NPI: 1275589079
Provider Name (Legal Business Name): ELI BENDAVID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 E 120TH ST
LOS ANGELES CA
90059-3026
US

IV. Provider business mailing address

PO BOX 16699
IRVINE CA
92623-6699
US

V. Phone/Fax

Practice location:
  • Phone: 424-338-1000
  • Fax:
Mailing address:
  • Phone: 949-263-8620
  • Fax: 949-263-1639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA69279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: