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General NPI Number Information
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NPI Number | 1790028561
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Entity Type | Individual
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Provider Name | BENJAMIN JAMES ARCHER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2013
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Last Update Date | 03/10/2020
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Provider Practice Location Address
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Address Line | 34800 BOB WILSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 650-269-8304
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Fax |
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Provider Business Mailing Address
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Address Line | US NAVAL HOSPITAL GUAM, EMERGENCY MEDICINE, DMS PSC 455 BOX 208
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City | FPO
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State | AP
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Zip | 96540
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Country | US
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Telephone | 671-482-4197
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M-2199
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License Number State | GU
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