Provider Demographics
NPI:1659511772
Name:BENOIT, VIVIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:BENOIT
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 1:2166 HAYES ST
Mailing Address - Street 2:SUITE #104
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1033
Mailing Address - Country:US
Mailing Address - Phone:415-379-7802
Mailing Address - Fax:
Practice Address - Street 1:2166 HAYES ST
Practice Address - Street 2:SUITE #104
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1033
Practice Address - Country:US
Practice Address - Phone:415-379-7802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAF61384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine