Individual
BENJAMIN J POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2821 OCEANSIDE BLVD, OCEANSIDE, CA 92054-4800
(760) 721-2781
(760) 721-9571
Mailing address
1216 WARMLANDS AVE, VISTA, CA 92084-4203
(760) 721-2781
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3720
CAS REGISTATION NUMBER
CA
Enumeration date
05/22/2007
Last updated
07/08/2007
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