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General NPI Number Information
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NPI Number | 1942438205
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Entity Type | Individual
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Provider Name | ASHLEY G BENNETT M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 4650 W SUNSET BLVD MS 76
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone | 323-669-2113
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Fax | 323-361-8003
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Provider Business Mailing Address
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Address Line | 4650 W SUNSET BLVD MS 76
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone | 323-669-2113
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Fax | 323-361-8003
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 27220
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME113308
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD11684
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A121634
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License Number State | CA
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