Healthcare Provider Details

I. General information

NPI: 1336130988
Provider Name (Legal Business Name): DANIEL R BENSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY AVE SUITE 100
SACRAMENTO CA
95825-6504
US

IV. Provider business mailing address

500 UNIVERSITY AVE SUITE 100
SACRAMENTO CA
95825-6504
US

V. Phone/Fax

Practice location:
  • Phone: 916-437-0570
  • Fax: 916-437-0570
Mailing address:
  • Phone: 916-437-0570
  • Fax: 916-437-0570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberG017561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: