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Individual

MARIA TERESA DATAN BENITEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1100 N PALM CANYON DR, SUITE 212, PALM SPRINGS, CA 92262-4414
(760) 327-7900
(760) 327-7905
Mailing address
1100 N PALM CANYON DR, SUITE 212, PALM SPRINGS, CA 92262-4414
(760) 327-7900
(760) 327-7905

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301092193
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
C55826
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0101240
CA
05
GR0101241
CA
05
GR0101242
CA
01
ZZZ27958Z
MEDICARE GROUP ID
CA
Enumeration date
06/02/2008
Last updated
05/21/2014
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