| Malibu Medical Corporation | |
|
23661 Pacific Coast Hwy Malibu CA 90265-4825 | |
| (310) 456-1603 | |
| (310) 456-5697 |
| Full Name | Malibu Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 23661 Pacific Coast Hwy, Malibu, California |
| Authorized Official Name and Position | Lisa M Benya (OWNER) |
| Authorized Official Contact | 3104561603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Malibu Medical Corporation 23661 Pacific Coast Hwy Malibu CA 90265-4825 Ph: (310) 456-1603 | Malibu Medical Corporation 23661 Pacific Coast Hwy Malibu CA 90265-4825 Ph: (310) 456-1603 |
| NPI Number | 1821287764 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 11/08/2022 |
| Medicare PECOS PAC ID | 1456361906 |
|---|---|
| Medicare Enrollment ID | O20060427000412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821287764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 20A7615 (California) | Primary |
| Provider Name | Lisa M Benya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972515781 PECOS PAC ID: 2567498132 Enrollment ID: I20050714000675 |
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