Provider Demographics
NPI:1487843280
Name:ARTHUR BENJAMIN, M.D. A PROF. MED. CORP
Entity Type:Organization
Organization Name:ARTHUR BENJAMIN, M.D. A PROF. MED. CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLUBCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-275-5533
Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:SUITE 709
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3701
Mailing Address - Country:US
Mailing Address - Phone:310-275-5533
Mailing Address - Fax:310-275-5523
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:SUITE 709
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-275-5533
Practice Address - Fax:310-275-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55562207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4522270001Medicare NSC
CAW18433Medicare PIN