Healthcare Provider Details

I. General information

NPI: 1386830792
Provider Name (Legal Business Name): BENJAMIN EDWARD MCGEE ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35000 GUADALCANAL ST BLDG 573
SAN DIEGO CA
92140-5599
US

IV. Provider business mailing address

4841 MOUNT BIGELOW DR
SAN DIEGO CA
92111-2525
US

V. Phone/Fax

Practice location:
  • Phone: 858-349-3278
  • Fax:
Mailing address:
  • Phone: 858-349-3278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: