Individual
JACOB BENFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 NORTH JACKSON AVENUE, SAN JOSE, CA 95116
(408) 923-7121
Mailing address
2100 POWELL STREET, SUITE 900, EMERYVILLE, CA 94608-1804
(510) 350-2664
(510) 879-4076
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A60475
CA
207P00000X
Emergency Medicine Physician
MD195812
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A604750
—
CA
Enumeration date
05/23/2006
Last updated
10/17/2019
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