Individual
MR. RIPUDAMAN S BENIWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1144 NORMAN DR STE 101, 1530 N BESSIE AVE, STE104, TRACY CA 95376 ( 2ND OFFICE), MANTECA, CA 95336-5959
(209) 239-0515
(209) 239-0504
Mailing address
1144 NORMAN DR STE 101, MANTECA, CA 95336-5959
(209) 835-2992
(209) 835-3296
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A67409
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A674090
—
CA
Enumeration date
01/27/2006
Last updated
10/14/2008
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