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NPI Code Detail

MEDICARE: TARA DEANNA BENESCH MD, MS

MEDICARE: TARA DEANNA BENESCH MD, MS
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
1207P00000XEmergency Medicine PhysicianA178049CA

General Provider Information

NPI Number : 1487117941
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA DEANNA BENESCH MD, MS
Provider Business Mailing Address
First Line : 3355 RICHMOND BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94611-5818
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3600 BROADWAY
Second Line :
City : OAKLAND
State : CA
Zip : 94611-5730
Country : US
Telephone Number : 510-752-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2019
Last Update Date : 01/14/2026

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