Individual
ROBERT BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 WILSHIRE BLVD STE 700, SANTA MONICA, CA 90401-3602
(310) 419-8799
Mailing address
100 WILSHIRE BLVD STE 700, SANTA MONICA, CA 90401-3602
(310) 419-8799
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
54216
CA
363AM0700X
Medical Physician Assistant
PA9110133
FL
Other
Enumeration date
12/01/2016
Last updated
10/28/2022
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