Healthcare Provider Details
I. General information
NPI: 1164592622
Provider Name (Legal Business Name): WILLIAM STEVEN BENKO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/09/2006
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3160 FOLSOM BLVD STE 2100
SACRAMENTO CA
95816-5266
US
IV. Provider business mailing address
3160 FOLSOM BLVD STE 2100
SACRAMENTO CA
95816-5266
US
V. Phone/Fax
- Phone: 916-734-3588
- Fax: 916-451-2014
- Phone: 916-734-3588
- Fax: 916-451-2012
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0402X |
| Taxonomy | Neurology with Special Qualifications in Child Neurology Physician |
| License Number | C144983 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: