Provider Demographics
NPI:1447344155
Name:PAUL C. BENESH, LIC. AC.
Entity type:Organization
Organization Name:PAUL C. BENESH, LIC. AC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CONRAD
Authorized Official - Last Name:BENESH
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC, DIPL AC
Authorized Official - Phone:661-317-7872
Mailing Address - Street 1:26014 TOPPER COURT
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381
Mailing Address - Country:US
Mailing Address - Phone:661-317-7872
Mailing Address - Fax:
Practice Address - Street 1:1850 E. PALMDALE BLVD.
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550
Practice Address - Country:US
Practice Address - Phone:661-224-1022
Practice Address - Fax:661-224-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTIN