Organization
RICHARD G BENNETT MD
Active
Organization
RICHARD G BENNETT MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD GARY BENNETT MD (OWNER)
(310) 315-0171
Entity
Organization
Contact information
Practice address
1301 20TH ST, SUITE 570, SANTA MONICA, CA 90404
(310) 315-0171
(310) 828-6647
Mailing address
1301 20TH ST, SUITE 570, SANTA MONICA, CA 90404
(310) 315-0171
(310) 828-6647
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
09/14/2010
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