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General NPI Number Information
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NPI Number | 1558499053
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Entity Type | Individual
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Provider Name | JAMES PAUL BENVENUTI MD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 1530 E COLORADO ST
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City | GLENDALE
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State | CA
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Zip | 91205-1514
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Country | US
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Telephone | 818-244-0222
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Fax | 818-243-5413
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Provider Business Mailing Address
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Address Line | 1530 E COLORADO ST
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City | GLENDALE
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State | CA
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Zip | 91205-1514
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Country | US
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Telephone | 818-244-0222
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Fax | 818-243-5413
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A22217
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | A-22217
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License Number State | CA
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