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General NPI Number Information
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NPI Number | 1518363225
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Entity Type | Individual
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Provider Name | JEFFREY BENCINI PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/06/2014
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 1799 MARLOW RD
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City | SANTA ROSA
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State | CA
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Zip | 95401-4474
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Country | US
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Telephone | 707-528-3062
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Fax |
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Provider Business Mailing Address
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Address Line | 1156 LILY AVE
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City | SUNNYVALE
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State | CA
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Zip | 94086-8301
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Country | US
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Telephone | 408-482-3742
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 70753
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License Number State | CA
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