Provider Demographics
NPI:1346944493
Name:DI BENEDETTO, SARAH LYN (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYN
Last Name:DI BENEDETTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 FIFTH AVENUE
Mailing Address - Street 2:MER-35
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92013-2105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4407 FIFTH AVENUE
Practice Address - Street 2:MER-35
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92013-2105
Practice Address - Country:US
Practice Address - Phone:619-260-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program