Individual
DR. NISSIM BENBASSAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2155 WEBSTER ST, SUITE 522, SAN FRANCISCO, CA 94115-2333
(415) 929-6531
Mailing address
5916 N BURTON AVE, SAN GABRIEL, CA 91775-2630
(626) 285-2702
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
58421
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000714
UNIVERSITY OF THE PACIFIC FACULTY ID
CA
01
—
58421
DENTAL LICENSE
CA
Enumeration date
02/04/2013
Last updated
02/04/2013
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