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Individual

BENJAMIN KEMINK MAXWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-5770
Mailing address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-5770

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A108124
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/18/2009
Last updated
07/06/2009
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