Individual
BENJAMIN JOHN CAUDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MSN, FNP-C
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(714) 418-3393
Mailing address
PO BOX 685, COLTON, CA 92324-0685
(714) 418-3393
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
95032060
CA
363L00000X
Nurse Practitioner
Primary
95013310
CA
Other
Enumeration date
08/25/2019
Last updated
05/06/2024
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