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Individual

DR. BEN C PALMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
150 S MARY AVE STE 4, NIPOMO, CA 93444-7821
(805) 929-1982
(805) 929-5052
Mailing address
150 S MARY AVE STE 4, NIPOMO, CA 93444-7821
(805) 929-1982
(805) 929-5052

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
100188
ID
152W00000X
Optometrist
Primary
13794
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1235463944
TYPE I (INDIVIDUAL) NPI
CA
05
1235463944
CA
01
1346539095
TYPE II (GROUP) NPI
CA
01
FI860A
GROUP MEDICARE PTAN
CA
Enumeration date
09/28/2009
Last updated
01/28/2025
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