Organization
TELEHEALTH INNOVATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BENYA DO (PRESIDENT)
(310) 456-1603
Entity
Organization
Contact information
Practice address
22741 PACIFIC COAST HWY STE 220, MALIBU, CA 90265-5097
(310) 341-0188
Mailing address
22741 PACIFIC COAST HWY STE 220, MALIBU, CA 90265-5097
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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