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Individual

MR. ERIC GUST BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, FNP

Contact information

Practice address
12700 WELCH ST, WATERFORD, CA 95386-8765
(209) 874-2345
(209) 874-3926
Mailing address
434 E FAIRMONT AVE, MODESTO, CA 95354-0207
(209) 918-7033

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
492134
CA
363LF0000X
Family Nurse Practitioner
Primary
13248
CA

Other

Enumeration date
08/08/2012
Last updated
03/07/2023
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