MEDICARE: MALKA BENONI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	A35765	CA

General Provider Information

NPI Number	:	1306891171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALKA BENONI MD

Provider Business Mailing Address
First Line	:	3023 BUNKER HILL ST
Second Line	:	SUITE #203
City	:	SAN DIEGO
State	:	CA
Zip	:	92109
Country	:	US
Telephone Number	:	858-581-2225
Fax Number	:	858-581-3870

Provider Business Practice Location Address
First Line	:	3023 BUNKER HILL ST
Second Line	:	SUITE #203
City	:	SAN DIEGO
State	:	CA
Zip	:	92109
Country	:	US
Telephone Number	:	858-581-2225
Fax Number	:	858-581-3870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	07/16/2018

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