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Organization
UNIVERSITE DU BENIN MEDICAL GROUP, INC.,
Active
Organization
UNIVERSITE DU BENIN MEDICAL GROUP, INC.,
Active
Other names
UNIVERSITE DU BENIN MEDICAL GROUP, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIANSI BONI MD (OWNER)
(805) 486-9100
Entity
Organization
Contact information
Practice address
650 HOBSON WAY # 204, OXNARD, CA 93030-6711
(805) 486-9100
(805) 486-7330
Mailing address
PO BOX 6299, TORRANCE, CA 90504
(805) 486-9100
(805) 486-7330
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
A45536
CA
207Q00000X
Family Medicine Physician
Primary
A45536
CA
208000000X
Pediatrics Physician
A45536
CA
208VP0014X
Interventional Pain Medicine Physician
A45536
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A455360
—
CA
Enumeration date
03/12/2007
Last updated
06/01/2010
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