Provider Demographics
NPI:1982890901
Name:BENOUNI, SARALEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SARALEEN
Middle Name:
Last Name:BENOUNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SARALEEN
Other - Middle Name:
Other - Last Name:BASSERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11500 W OLYMPIC BLVD STE 630
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1538
Mailing Address - Country:US
Mailing Address - Phone:310-393-1550
Mailing Address - Fax:310-478-3601
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 630
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1538
Practice Address - Country:US
Practice Address - Phone:310-393-1550
Practice Address - Fax:310-478-3601
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101331207K00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABU234XMedicare PIN