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Organization

BEN BHUPENDRA PRADHAN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BEN BHUPENDRA PRADHAN MD, MS (PRESIDENT)
(310) 828-7757
Entity
Organization

Contact information

Practice address
1301 20TH ST, SUITE 400, SANTA MONICA, CA 90404-2050
(310) 828-7757
(310) 828-6687
Mailing address
1301 20TH ST, SUITE 400, SANTA MONICA, CA 90404-2050
(310) 828-7757
(310) 828-6687

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W17987
MEDICARE GROUP NUMBER
CA
Enumeration date
10/30/2007
Last updated
05/01/2008
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