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General NPI Number Information
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NPI Number | 1851917348
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Entity Type | Individual
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Provider Name | ILAN YAACOV BENADOR-SHEN MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1001 POTRERO AVENUE BLDG. 5, 1ST FL.
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City | SAN FRANCISCO
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State | CA
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Zip | 94110
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Country | US
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Telephone | 628-206-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 DIVISADERO ST RM C250
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-3010
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Country | US
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Telephone | 415-885-7464
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ETLL-738
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A189946
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License Number State | CA
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