Bennet, Justin David

Bennet, Justin David is an individual health care provider with primary practice located at 1505 Soquel Dr Suite12, Santa Cruz CA 95065-1716. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Hepatology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Bennet, Justin David can be contacted via phone (831) 713-5050.

Contact Information

Primary practice address
1505 Soquel Dr Suite12 Santa Cruz CA 95065-1716
Phone: (831) 713-5050
Fax: (831) 475-0101
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 0101840379 Virginia
Allopathic & Osteopathic Physicians / Hepatology 207RI0008X 0101840379 Virginia

Profile Details

NPI number 1134299308
LBN Legal business name Bennet, Justin David
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Jun 15th, 2012 - about 13 years ago

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 1134299308 NPPES
Virginia MEDICAID 005847958

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