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General NPI Number Information
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NPI Number | 1578182739
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Entity Type | Individual
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Provider Name | CECIL MAYRA BENITEZ M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 1100 SAN BERNARDINO RD STE 1100
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City | UPLAND
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State | CA
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Zip | 91786-4952
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Country | US
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Telephone | 909-949-2242
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Fax | 909-981-5783
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Provider Business Mailing Address
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Address Line | PO BOX 512185
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City | LOS ANGELES
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State | CA
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Zip | 90051-0185
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Country | US
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Telephone |
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | A188987
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License Number State | CA
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