Provider Demographics
NPI:1235530627
Name:BENJAMIN TALEI, MD
Entity Type:Organization
Organization Name:BENJAMIN TALEI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:AZIZ
Authorized Official - Last Name:TALEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-288-0641
Mailing Address - Street 1:120 S SPALDING DR
Mailing Address - Street 2:SUITE 236
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1800
Mailing Address - Country:US
Mailing Address - Phone:310-288-0641
Mailing Address - Fax:310-288-0641
Practice Address - Street 1:120 S SPALDING DR
Practice Address - Street 2:SUITE 236
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1800
Practice Address - Country:US
Practice Address - Phone:310-288-0641
Practice Address - Fax:310-288-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126798207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty