Kevin Bennett

Individual provider Active NPI Case Manager/Care Coordinator · Carson, CA

NPI 1285218677 · NPPES record last updated May 11, 2021

Key facts

NPI
1285218677
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
19503 Galway Ave
Carson, CA 90746-1923
Phone
(310) 817-5267
NPI assigned
May 11, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Home Care, Inc. Past
since May 16, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

19503 Galway Ave
Carson, CA 90746-1923

Mailing address

20695 S Western Ave Ste 132
Torrance, CA 90501-1834
Phone (424) 271-7414

Other providers in Carson, CA

All providers in Carson, CA · Case Manager/Care Coordinator in California

Sources for this page

Verify at the official NPI Registry.