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NPI Code Detail

MEDICARE: MR. BEN SAMONTE

MEDICARE:  MR. BEN  SAMONTE
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
1163W00000XRegistered Nurse95248450CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120131241OTHERCAKAISER

General Provider Information

NPI Number : 1689300352
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BEN SAMONTE
Provider Business Mailing Address
First Line : 723 EASTSHORE TER UNIT 57
Second Line :
City : CHULA VISTA
State : CA
Zip : 91913-2418
Country : US
Telephone Number : 619-274-4984
Fax Number :
Provider Business Practice Location Address
First Line : 5520 OVERLAND AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1206
Country : US
Telephone Number : 858-694-3900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2022
Last Update Date : 07/26/2022

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Directions to “ MR. BEN SAMONTE ” Practice Location

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