Individual
LAUREN ALEXANDRIA BENNALLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1000
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A14245
CA
207P00000X
Emergency Medicine Physician
S3632
TX
Other
Enumeration date
05/05/2014
Last updated
06/26/2024
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