Basic Information
| Provider Information | |||||||||
| NPI: | 1174848444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENGIAMIN | ||||||||
| FirstName: | DEENA | ||||||||
| MiddleName: | IBRAHIM | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 N FRESNO ST | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937012302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594996439 | ||||||||
| FaxNumber: | 5594996441 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 N FRESNO ST | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937012302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594996439 | ||||||||
| FaxNumber: | 5594996441 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2010 | ||||||||
| LastUpdateDate: | 11/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A119444 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.