Individual
DR. STEPHEN ANDREW BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
555 MARIN ST, SUITE 290, THOUSAND OAKS, CA 91360-4236
(805) 497-6979
(805) 777-7028
Mailing address
555 MARIN ST, SUITE 290, THOUSAND OAKS, CA 91360-4236
(805) 497-6979
(805) 777-7028
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
E4426
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4426
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E44260
—
CA
01
—
W22604
GROUP MEDICARE PIN
CA
01
—
W22604A
GROUP MEDICARE PIN
CA
Enumeration date
07/19/2006
Last updated
01/30/2015
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