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Individual
DR. BENJAMIN DOMINGO DACULA
Active
Individual
DR. BENJAMIN DOMINGO DACULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25149
OK
207Q00000X
Family Medicine Physician
40182
KY
207Q00000X
Family Medicine Physician
Primary
C54857
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25149
MEDICAL LICENSE
OK
01
—
40182
MEDICAL LICENSE
KY
01
—
C54857
MEDICAL LICENSE
CA
Enumeration date
06/26/2006
Last updated
11/29/2021
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