Provider Demographics
NPI:1821490970
Name:BENEDICT YH CHING
Entity Type:Organization
Organization Name:BENEDICT YH CHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:YH
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-861-4631
Mailing Address - Street 1:18111 BROOKHURST ST
Mailing Address - Street 2:SUITE3400
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6728
Mailing Address - Country:US
Mailing Address - Phone:714-861-4631
Mailing Address - Fax:714-861-4631
Practice Address - Street 1:18111 BROOKHURST ST
Practice Address - Street 2:SUITE 3400
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6728
Practice Address - Country:US
Practice Address - Phone:714-861-4637
Practice Address - Fax:714-861-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3380332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies