Provider Demographics
NPI:1447654348
Name:HALPREN, BENJAMIN AARON (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:AARON
Last Name:HALPREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 CATALPA DR
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-2104
Mailing Address - Country:US
Mailing Address - Phone:650-327-8980
Mailing Address - Fax:650-322-3501
Practice Address - Street 1:168 CATALPA DR
Practice Address - Street 2:
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-2104
Practice Address - Country:US
Practice Address - Phone:650-327-8980
Practice Address - Fax:650-322-3501
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19220174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG19220OtherMEDICAL LICENSE