Provider Demographics
NPI:1447226386
Name:BENIK, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BENIK
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 1:23832 ROCKFIELD BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-2876
Mailing Address - Country:US
Mailing Address - Phone:949-770-8115
Mailing Address - Fax:949-770-2017
Practice Address - Street 1:23832 ROCKFIELD BLVD STE 210
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-2876
Practice Address - Country:US
Practice Address - Phone:949-770-8115
Practice Address - Fax:949-770-2017
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG60765207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE83900Medicare UPIN
CAWG60765AMedicare PIN