# MANTECA GASTROENTEROLOGY ASSOCIATES INC

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

## Provider details

- **NPI number:** 1093599490
- **Authorized official:** RIPUDMAN S BENIWAL MD (OWNER)
- **Authorized official phone:** (775) 747-5050

## Contact information

- **Practice address:** 1144 NORMAN DR STE 101, MANTECA, CA 95336-5959
- **Practice address phone:** (209) 239-0515
- **Mailing address:** PO BOX 34120, RENO, NV 89533-4120
- **Mailing address phone:** (775) 747-5050
- **Mailing address fax:** (775) 747-5005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/24/2023
- **Last updated:** 08/24/2023