Provider Demographics
NPI:1184811952
Name:WOO, BENJAMIN KAI PAN (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:KAI PAN
Last Name:WOO
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:KAI
Other - Middle Name:PAN
Other - Last Name:WOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14445 OLIVE VIEW DRIVE, COTTAGE H1
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14445 OLIVE VIEW DRIVE, COTTAGE H1
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:747-210-4433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA967012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA96701OtherMEDICAL LICENSE
CABW9951268OtherDEA REGISTRATION NUMBER