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NPI Code Detail

MEDICARE: PETER BENEDICT

MEDICARE:   PETER  BENEDICT
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
1174400000XSpecialist

General Provider Information

NPI Number : 1962557447
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER BENEDICT
Provider Business Mailing Address
First Line : PO BOX 463
Second Line :
City : LOS ALAMOS
State : CA
Zip : 93440-0463
Country : US
Telephone Number : 805-705-1880
Fax Number :
Provider Business Practice Location Address
First Line : 114 E HALEY ST
Second Line : STE D
City : SANTA BARBARA
State : CA
Zip : 93101-2347
Country : US
Telephone Number : 805-962-1004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 07/08/2007

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Directions to “ PETER BENEDICT ” Practice Location

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