Provider Demographics
NPI:1245387562
Name:TOY, BENSON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BENSON
Middle Name:
Last Name:TOY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 LAS GALLINAS AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3431
Mailing Address - Country:US
Mailing Address - Phone:415-479-1993
Mailing Address - Fax:415-479-0128
Practice Address - Street 1:750 LAS GALLINAS AVE STE 104
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3431
Practice Address - Country:US
Practice Address - Phone:415-479-1993
Practice Address - Fax:415-479-0128
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293201835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA371190Medicaid
CA0744950001Medicare ID - Type Unspecified