Benham, Lisa

Benham, Lisa is an individual health care provider with primary practice located at 2791 Green River Rd Suite 106, Corona CA 92882-7426. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Benham, Lisa can be contacted via phone (951) 736-2020.

Contact Information

Primary practice address
2791 Green River Rd Suite 106 Corona CA 92882-7426
Phone: (951) 736-2020
Fax: (951) 736-2002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT9202T California

Profile Details

NPI number 1518936947
LBN Legal business name Benham, Lisa
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518936947 NPPES
California MEDICAID SD0092020

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