Basic Information
| Provider Information | |||||||||
| NPI: | 1447326533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENDAOUD | ||||||||
| FirstName: | REDA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 S MYRTLE AVE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | MONROVIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910163427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263573258 | ||||||||
| FaxNumber: | 6263010868 | ||||||||
| Practice Location | |||||||||
| Address1: | 902 S MYRTLE AVE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | MONROVIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910163427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263573258 | ||||||||
| FaxNumber: | 6263010868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 05/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | A82508 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084P0804X | A82508 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.