Organization
BENJAMIN LI, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN LI M.D. (DIRECT OWNER)
(818) 888-7815
Entity
Organization
Contact information
Practice address
24355 LYONS AVE, STE.# 120, SANTA CLARITA, CA 91321-2300
(661) 255-6644
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A60762
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
A60762
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A60762
MEDICARE SO CALIF
CA
01
—
GR00063280
MEDICAL/EDS
CA
Enumeration date
07/12/2007
Last updated
07/12/2007
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