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General NPI Number Information
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NPI Number | 1659489425
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Entity Type | Individual
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Provider Name | BENITO RUBEN CONTRERAS PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8556 FLORENCE AVE
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City | DOWNEY
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State | CA
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Zip | 90240-4015
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Country | US
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Telephone | 562-861-0101
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Fax | 562-861-9898
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Provider Business Mailing Address
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Address Line | 16600 ORANGE AVE #104
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City | PARAMOUNT
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State | CA
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Zip | 90723-5353
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Country | US
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Telephone | 562-790-2428
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Fax | 562-790-2428
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18278
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License Number State | CA
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