Individual
DR. BENJAMIN THOMAS STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
612 W DUARTE RD, SUITE 304, ARCADIA, CA 91007-7602
(626) 446-4461
(626) 445-0647
Mailing address
612 W DUARTE RD, SUITE 304, ARCADIA, CA 91007-7602
(626) 446-4461
(626) 445-0647
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G19825
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G19825
STATE MEDICAL LICENSE NUM
CA
01
—
YYY48961Y
BLUE SHIELD OF CALIF GR N
CA
05
—
YYY48961Y
—
CA
Enumeration date
10/14/2006
Last updated
07/08/2007
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