Provider Demographics
NPI:1639296767
Name:BENJAMIN G COX JR MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BENJAMIN G COX JR MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:GOULD
Authorized Official - Last Name:COX
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:951-970-2882
Mailing Address - Street 1:29501 SPRINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7723
Mailing Address - Country:US
Mailing Address - Phone:951-970-2882
Mailing Address - Fax:
Practice Address - Street 1:25485 MEDICAL CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6927
Practice Address - Country:US
Practice Address - Phone:951-970-2882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty