Individual
GREGORY WILLIAM BENSCH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4628 GEORGETOWN PL, STOCKTON, CA 95207-6204
(209) 478-6177
(209) 478-6219
Mailing address
4628 GEORGETOWN PL, STOCKTON, CA 95207-6204
(209) 478-6177
(209) 478-6219
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A61795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A617950
—
CA
01
—
ZZZ75721Z
MEDI-CAL GROUP ID NUMBER
CA
Enumeration date
02/10/2006
Last updated
07/08/2007
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