Provider Demographics
NPI:1952459992
Name:BUSFIELD, BENJAMIN T (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:T
Last Name:BUSFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 SAN MIGUEL DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8606
Mailing Address - Country:US
Mailing Address - Phone:925-528-2663
Mailing Address - Fax:925-522-8874
Practice Address - Street 1:1808 SAN MIGUEL DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8606
Practice Address - Country:US
Practice Address - Phone:925-528-2663
Practice Address - Fax:925-522-8874
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82241207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A822410Medicaid