Provider Demographics
NPI:1336555960
Name:FRANCO, BENJAMIN JR
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:FRANCO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10983 MIDDLEBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-5925
Mailing Address - Country:US
Mailing Address - Phone:951-255-2215
Mailing Address - Fax:
Practice Address - Street 1:10983 MIDDLEBOROUGH RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5925
Practice Address - Country:US
Practice Address - Phone:951-255-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6833225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant