MEDICARE: ERIC BENNION CCP

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	208600000X	Surgery Physician	259214	WI

General Provider Information

NPI Number	:	1699600098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC BENNION CCP

Provider Business Mailing Address
First Line	:	85 CLEAVELAND RD UNIT 228
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-3716
Country	:	US
Telephone Number	:	925-324-8406
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 CLEAVELAND RD UNIT 228
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-3716
Country	:	US
Telephone Number	:	925-324-8406
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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