Individual
BRANDON G. BENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
711 N TAYLOR ST, GUNNISON, CO 81230-2296
(970) 641-1456
(970) 641-4461
Mailing address
3800 SUMMITVIEW AVE, YAKIMA, WA 98902-2715
(509) 248-7849
(509) 248-8291
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
60914678
WA
207Y00000X
Otolaryngology Physician
Primary
DR.0070421
CO
207Y00000X
Otolaryngology Physician
G89294
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA874Z
PTAN FOR RIDEOUT MEDICAL ASSOCIATES, INC.
CA
Enumeration date
10/13/2006
Last updated
05/09/2024
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