Organization
GARY BENNETT M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA COFFMAN (BILLER)
(714) 547-3346
Entity
Organization
Contact information
Practice address
2601 E CHAPMAN AVE, ORANGE, CA 92869
(714) 633-0011
Mailing address
1913 E 17TH ST STE 118, SANTA ANA, CA 92705-8627
(714) 547-3346
(714) 547-3252
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G40059
CA
Other
Enumeration date
05/09/2007
Last updated
06/12/2018
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