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NPI Code Detail

MEDICARE: DR. BENJAMIN N GILMORE

MEDICARE: DR. BENJAMIN N GILMORE
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
1207Q00000XFamily Medicine PhysicianA88735CA

General Provider Information

NPI Number : 1396770178
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN N GILMORE
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD
Second Line : SUITE 400
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-319-4700
Fax Number :
Provider Business Practice Location Address
First Line : 1920 COLORADO AVE
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-3414
Country : US
Telephone Number : 310-319-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 05/12/2014

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Directions to “ DR. BENJAMIN N GILMORE ” Practice Location

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