Provider Demographics
NPI:1790195493
Name:FEIG, BENYAPA
Entity Type:Individual
Prefix:
First Name:BENYAPA
Middle Name:
Last Name:FEIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 DRIVER LN
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-1329
Mailing Address - Country:US
Mailing Address - Phone:909-593-4540
Mailing Address - Fax:
Practice Address - Street 1:2156 DRIVER LN
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-1329
Practice Address - Country:US
Practice Address - Phone:909-593-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist