Provider Demographics
NPI:1952949976
Name:STEIN, BENJAMIN W (PT)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:W
Last Name:STEIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 QUAIL CT STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5570
Mailing Address - Country:US
Mailing Address - Phone:925-977-9300
Mailing Address - Fax:
Practice Address - Street 1:39 QUAIL CT STE 300
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5570
Practice Address - Country:US
Practice Address - Phone:925-977-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT297743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist