Provider Demographics
NPI:1831270545
Name:BENSIMON, RICHARD HECTOR (MD BOARD CERTIFIED)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HECTOR
Last Name:BENSIMON
Suffix:
Gender:M
Credentials:MD BOARD CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 NW 14TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209
Mailing Address - Country:US
Mailing Address - Phone:203-372-3500
Mailing Address - Fax:203-372-8889
Practice Address - Street 1:120 NW 14TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209
Practice Address - Country:US
Practice Address - Phone:503-771-1883
Practice Address - Fax:971-222-1391
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0357332086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTA61901Medicare UPIN
CT240000137Medicare ID - Type Unspecified