Provider Demographics
NPI:1154450336
Name:BENDER, HENRY ERIC (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:ERIC
Last Name:BENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:760 WESTWOOD PLZ
Mailing Address - Street 2:C8-222
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5055
Mailing Address - Country:US
Mailing Address - Phone:310-794-9251
Mailing Address - Fax:310-206-9078
Practice Address - Street 1:760 WESTWOOD PLZ
Practice Address - Street 2:C8-222
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5055
Practice Address - Country:US
Practice Address - Phone:310-794-9251
Practice Address - Fax:310-206-9078
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA972712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry