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Individual

ALICE LEE A BENJAMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNS-BC, FNP-C

Contact information

Practice address
11325 RIVERSIDE DR, TOLUCA LAKE, CA 91602-1220
(619) 252-8796
Mailing address
11333 MOORPARK ST # 30, STUDIO CITY, CA 91602-2618
(619) 813-8905

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704326451
MI
363LF0000X
Family Nurse Practitioner
Primary
95016952
CA
363LF0000X
Family Nurse Practitioner
F353226-01
NY
363LF0000X
Family Nurse Practitioner
TPAN2621
FL
364S00000X
Clinical Nurse Specialist
3231
CA

Other

Enumeration date
09/20/2020
Last updated
09/01/2024
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