Basic Information
| Provider Information | |||||||||
| NPI: | 1003016262 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BENJAMIN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | AARON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 BROADWAY | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946074099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102085946 | ||||||||
| FaxNumber: | 5102085947 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 BROADWAY | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946074099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102085946 | ||||||||
| FaxNumber: | 5102085947 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2007 | ||||||||
| LastUpdateDate: | 07/24/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083P0901X | C33673 | CA | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine |
No ID Information.