Individual
DR. BENJAMIN N POTKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1595 SOQUEL DR, SANTA CRUZ, CA 95065-1719
(831) 761-1680
Mailing address
1595 SOQUEL DR, SANTA CRUZ, CA 95065-1719
(831) 761-1680
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G55040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720100480
GROUP NPI
CA
Enumeration date
01/25/2007
Last updated
06/13/2024
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