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Individual

BENIGNO CANCEKO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1150 N INDIAN CANYON DR, PALM SPRINGS, CA 92262-4872
(760) 323-6511
(530) 243-0445
Mailing address
PO BOX 492680, REDDING, CA 96049-2680
(530) 243-0440
(530) 243-0445

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A33012
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A330120
CA
Enumeration date
06/02/2006
Last updated
07/09/2007
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