Organization
90265 MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MARIE BENYA DO (PRESIDENT)
(310) 341-0188
Entity
Organization
Contact information
Practice address
23661 PACIFIC COAST HIGHWAY, MALIBU, CA 90265
(310) 341-0188
(818) 668-3604
Mailing address
23661 PACIFIC COAST HIGHWAY, MALIBU, CA 90265
(310) 456-1603
(310) 456-5697
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
08/15/2019
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