Healthcare Provider Details

I. General information

NPI: 1427532472
Provider Name (Legal Business Name): HASSAN BENCHEQROUN M.D., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2018
Last Update Date: 02/08/2020
Certification Date: 02/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E TACHEVAH DR STE 1W104
PALM SPRINGS CA
92262-5772
US

IV. Provider business mailing address

51753 EL DORADO DR
LA QUINTA CA
92253-9034
US

V. Phone/Fax

Practice location:
  • Phone: 760-618-1353
  • Fax: 760-259-2001
Mailing address:
  • Phone: 760-619-2309
  • Fax: 866-428-0708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: PEGGY STEINER
Title or Position: BUSINESS MGR
Credential:
Phone: 760-619-2309