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General NPI Number Information
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NPI Number | 1154622322
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Entity Type | Organization
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Legal Business Name | BENTE KAISER M.D., INC
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 4407 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90037-2731
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Country | US
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Telephone | 323-233-0249
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Fax |
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Provider Business Mailing Address
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Address Line | 4407 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90037-2731
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Country | US
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Telephone | 323-233-0249
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENTE L.N. KAISER
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Credential | M.D.
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Telephone | 323-233-0249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A103372
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License Number State | CA
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