Active NPI
Charles David Benson
- Specialist
- Oakland, CA
National Provider Identifier
1114083573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 7200 Bancroft Ave
Eastmont Town Center BLDG. B Suite 133
Oakland, CA 94605-2403 - Phone
- (510) 553-8500
- Fax
- (510) 553-8550
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
7200 Bancroft Ave
Eastmont Town Center BLDG. B Suite 133
Oakland, CA 94605-2403
Mailing address
684 Memorial Way
No. 4
Hayward, CA 94541-5835
Phone (510) 553-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801983960 | Other | CA | ICM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114083573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "684 MEMORIAL WAY",
"address_2": "NO. 4",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945415835",
"telephone_number": "510-553-8500",
"fax_number": "510-553-8550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 BANCROFT AVE",
"address_2": "EASTMONT TOWN CENTER BLDG. B SUITE 133",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946052403",
"telephone_number": "510-553-8500",
"fax_number": "510-553-8550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "CHARLES",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ICM",
"identifier": "1801983960",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.