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General NPI Number Information
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NPI Number | 1235175894
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Entity Type | Individual
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Provider Name | ISABEL BENAVIDES MD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 250 PROSPECT PL
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City | CORONADO
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State | CA
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Zip | 92118-1943
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Country | US
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Telephone | 480-967-6500
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Fax | 480-967-6540
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Provider Business Mailing Address
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Address Line | 27068 LA PAZ RD STE 299
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3041
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Country | US
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Telephone | 505-870-3369
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2002-0010
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A68376
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License Number State | CA
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