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Individual

BEHNAM BEN SHENASSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2750 W BROADWAY, LOS ANGELES, CA 90041-1050
(818) 241-3125
(818) 241-1652
Mailing address
PO BOX 4186, GLENDALE, CA 91222-0186
(323) 543-4250
(323) 543-4255

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A76062
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A760620
CA
Enumeration date
09/22/2006
Last updated
08/27/2020
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