Slade, John Benjamin
Slade, John Benjamin is an sole proprietor health care provider with primary practice located at 101 Bodin Cir , Travis Afb CA 94535. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is his primary health care specialty. Slade, John Benjamin can be contacted via phone (707) 423-3987.Contact Information
Primary practice address
101 Bodin Cir
Travis Afb CA 94535
Phone: (707) 423-3987
Fax: (707) 423-5356
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine | 2083P0011X | A35154 | California |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A35154 | California |
Profile Details
| NPI number | 1457442394 |
|---|---|
| LBN Legal business name | Slade, John Benjamin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Jun 18th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457442394 | NPPES |
| California | MEDICAID | 00A351541 |
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