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General NPI Number Information
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NPI Number | 1174577613
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Entity Type | Organization
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Legal Business Name | BENSON FAMILY MEDICAL GROUP INC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 41555 COOK ST STE 130
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City | PALM DESERT
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State | CA
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Zip | 92211
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Country | US
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Telephone | 760-340-2682
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Fax | 760-773-9695
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Provider Business Mailing Address
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Address Line | 41555 COOK ST STE 130
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City | PALM DESERT
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State | CA
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Zip | 92211
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Country | US
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Telephone | 760-340-2682
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Fax | 760-773-9695
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Authorized Official
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Title or Position | PRESIDENT
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Name | AURORA L BENSON
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Credential | DO
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Telephone | 760-340-2682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A5361
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A4564
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License Number State | CA
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