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General NPI Number Information
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NPI Number | 1124996020
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Entity Type | Individual
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Provider Name | BEN BENDER
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Gender | Male
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 742 WASHINGTON BLVD
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5543
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Country | US
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Telephone | 310-881-9045
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Fax | 888-298-5303
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Provider Business Mailing Address
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Address Line | 12780 VENICE BLVD APT 9
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City | LOS ANGELES
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State | CA
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Zip | 90066-3722
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Country | US
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Telephone | 937-765-6086
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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