Healthcare Provider Details

I. General information

NPI: 1992802151
Provider Name (Legal Business Name): BENJAMIN R SABEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMIE SABEN MD

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10670 WEXFORD ST
SAN DIEGO CA
92131-3940
US

IV. Provider business mailing address

10670 WEXFORD ST
SAN DIEGO CA
92131-3940
US

V. Phone/Fax

Practice location:
  • Phone: 858-499-2600
  • Fax: 858-621-4022
Mailing address:
  • Phone: 858-499-2600
  • Fax: 858-621-4022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberA76666
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberA76666
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA76666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: