Individual
DR. THOMAS G BENVENUTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 SUPERIOR AVENUE, SUITE 330, NEWPORT BEACH, CA 92663
(949) 478-7373
(949) 650-2898
Mailing address
520 SUPERIOR AVE, SUITE 330, NEWPORT BEACH, CA 92663-3637
(949) 478-7373
(949) 650-2898
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G52876
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G52876
STATE LICENSE
CA
Enumeration date
07/09/2006
Last updated
08/02/2012
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