| Richard Anthony Benavidez, PA | |
|
400 N Pepper Ave, Colton, CA 92324-1801 | |
| (909) 580-1000 | |
| Not Available |
| Full Name | Richard Anthony Benavidez |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 400 N Pepper Ave, Colton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013445691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA54879 (California) | Primary |
| Entity Name | El-bershawi Medical Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386813103 PECOS PAC ID: 9032298492 Enrollment ID: O20080509000414 |
| Entity Name | Providence Healthcare Partners Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699157701 PECOS PAC ID: 2163723610 Enrollment ID: O20151229000900 |
| Entity Name | Evergreen Spine and Pain Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760159198 PECOS PAC ID: 6507263688 Enrollment ID: O20210916003002 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Anthony Benavidez, PA 1 Country Wood Dr, Pomona, CA 91766-4819 Ph: (816) 835-1048 | Richard Anthony Benavidez, PA 400 N Pepper Ave, Colton, CA 92324-1801 Ph: (909) 580-1000 |
Tiffany Jackie Hwang, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave # 205, Colton, CA 92324 Phone: 909-331-9598 |
Lawrence David Gates, P.A-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N. Pepper Avenue, Colton, CA 92324 Phone: 909-580-1400 |
Mrs. Amy Elizabeth Dahlberg, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-354-2195 |
Olivia Sophia Zetty, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 400 N Pepper Ave Ste 2m206, Colton, CA 92324 Phone: 317-900-3912 |
Brian Kent Heaton, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-3390 |
Emma Werner Oliver, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-1000 |
Azizi Rahman Bailey, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, 6th Floor South (dept Of Orthopedic Surgery), Colton, CA 92324 Phone: 909-580-6353 |