T Leroy Benson, M.D.
Individual provider Active NPI Anesthesiology Physician · Greenbrae, CA
NPI 1720016637 · NPPES record last updated Apr 8, 2009
Key facts
- NPI
- 1720016637
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- C28884 (CA)
- Practice address
- 250 Bon Air Rd
Greenbrae, CA 94904-1702 - Phone
- (415) 454-2218
- Fax
- (415) 485-6862
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C28884 | CA | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | C28884 | CA | Yes |
Addresses
Primary practice location
250 Bon Air Rd
Greenbrae, CA 94904-1702
Mailing address
250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 454-2218
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C288840 | Medicaid | CA |
Other providers in Greenbrae, CA
- Caitlin Kingston Leff Beale
- Stephen Ronald Bearg
- Matthew Bedell
- Mark Alan Bennett
- Patrick Mulvey Bennett
- Alia Marie Berlin
- David H Berman
- Richard Ira Bernstein
- Theresa M. Berta
- Jenna Bertsch Dobrick
All providers in Greenbrae, CA · Anesthesiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.