Healthcare Provider Details

I. General information

NPI: 1417046541
Provider Name (Legal Business Name): LLOYD BENJAMIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 BLANCO CIR STE B
SALINAS CA
93901-4421
US

IV. Provider business mailing address

1834 STONE AVE SUITE 2B
SAN JOSE CA
95125-1306
US

V. Phone/Fax

Practice location:
  • Phone: 813-757-9300
  • Fax: 813-757-0139
Mailing address:
  • Phone: 408-995-0102
  • Fax: 408-995-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC29323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: