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Organization
PORT MEDICAL WELLNESS, INC.
Active
Organization
PORT MEDICAL WELLNESS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURENT RUBEN BENHAMOU D.O. (PARTNER)
(310) 522-5811
Entity
Organization
Contact information
Practice address
512 N AVALON BLVD, WILMINGTON, CA 90744-5806
(310) 816-2943
(310) 816-9393
Mailing address
PO BOX 128, C/O STELLA REDENSKI, PACIFIC PALISADES, CA 90272-0128
(310) 522-5811
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
10/03/2008
Last updated
10/14/2008
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