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Provider Information for 1235386251

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. TRACY DANIEL BENHAMOU DDS

Gender: MALE

Individual NPI: 1235386251

Calendar   Last Updated:  2008-08-21
  Certification Date: 

Details

Name Value
NPI 1235386251
Enumeration Date 2008-08-21
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 62 OAK ST
BRENTWOOD, CA 94513-1333
United States

Phone: 925-634-9237 | Fax: 925-634-9238
View Map External Link
Primary Practice Address 62 OAK ST
BRENTWOOD, CA 94513-1333
United States

Phone: 925-634-9237 | Fax: 925-634-9238
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 49062