# GARY BENNETT M.D. INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003020074
- **Authorized official:** DIANA COFFMAN (BILLER)
- **Authorized official phone:** (714) 547-3346

## Contact information

- **Practice address:** 2601 E CHAPMAN AVE, ORANGE, CA 92869
- **Practice address phone:** (714) 633-0011
- **Mailing address:** 1913 E 17TH ST STE 118, SANTA ANA, CA 92705-8627
- **Mailing address phone:** (714) 547-3346
- **Mailing address fax:** (714) 547-3252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | G40059 | CA | Yes |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 06/12/2018