Provider Demographics
NPI:1033321385
Name:BENSON, DEAN MITCHELL (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:MITCHELL
Last Name:BENSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16458 BOLSA CHICA ST
Mailing Address - Street 2:# 407
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-2603
Mailing Address - Country:US
Mailing Address - Phone:714-840-0920
Mailing Address - Fax:
Practice Address - Street 1:16458 BOLSA CHICA ST
Practice Address - Street 2:# 407
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-2603
Practice Address - Country:US
Practice Address - Phone:714-840-0920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22967111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician