Individual
JEANNETTE BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
811 E. 11TH STREET SUITE 101, UPLAND, CA 91786
(909) 981-5970
(909) 981-5980
Mailing address
811 EAST 11TH STREET SUITE 101, UPLAND, CA 91786
(909) 981-5970
(909) 981-5980
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
A39542
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A289070
—
CA
Enumeration date
06/27/2006
Last updated
07/08/2007
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