Organization
GREEN VALLEY LASER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S. BENJAMIN M.D. (DIRECTOR)
(831) 722-2445
Entity
Organization
Contact information
Practice address
160 GREEN VALLEY RD, SUITE 201, FREEDOM, CA 95019-3160
(831) 722-2445
(831) 722-6032
Mailing address
160 GREEN VALLEY RD, SUITE 201, FREEDOM, CA 95019-3160
(831) 722-2445
(831) 722-6032
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
G75256 MED DIRECTOR
CA
Other
Enumeration date
11/03/2006
Last updated
08/22/2020
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