Provider Demographics
NPI:1376506725
Name:BENSKY, NORMAN (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:
Last Name:BENSKY
Suffix:
Gender:M
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:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:WILLOW CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95573-0726
Mailing Address - Country:US
Mailing Address - Phone:530-629-3111
Mailing Address - Fax:530-629-3122
Practice Address - Street 1:38883 HIGHWAY 299
Practice Address - Street 2:
Practice Address - City:WILLOW CREEK
Practice Address - State:CA
Practice Address - Zip Code:95573-0726
Practice Address - Country:US
Practice Address - Phone:530-629-3111
Practice Address - Fax:530-629-3122
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54910207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G549100Medicaid
CA00G549100Medicaid