Individual
LUIZ ENRIQUE GOMEZ BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3333 14TH ST, RIVERSIDE, CA 92501-3858
(951) 203-0819
Mailing address
3909 TERRACINA DR, RIVERSIDE, CA 92506-0150
(951) 203-0819
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
03/18/2025
Last updated
11/03/2025
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