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General NPI Number Information
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NPI Number | 1497827133
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Entity Type | Individual
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Provider Name | ZAN BENJAMIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1307 W 6TH ST SUITE #113
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City | CORONA
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State | CA
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Zip | 92882-3294
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Country | US
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Telephone | 951-278-8910
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Fax | 951-278-9895
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Provider Business Mailing Address
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Address Line | 1307 W 6TH ST SUITE #113
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City | CORONA
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State | CA
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Zip | 92882-3294
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Country | US
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Telephone | 951-278-8910
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Fax | 951-278-9895
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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 | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | A54540
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License Number State | CA
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