Mark Benson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A4564 Issued in CA

Practice address

78120 Wildcat Dr
Palm Desert, CA 92211-1140

Phone

(760) 340-2682

Fax

(760) 773-9695

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1760506745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78120 WILDCAT DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922111140",
            "telephone_number": "760-340-2682",
            "fax_number": "760-773-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78120 WILDCAT DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922111140",
            "telephone_number": "760-340-2682",
            "fax_number": "760-773-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174577613",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0069290",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX45640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beneficial CDC
• Hany Samuel Benjamin, PHARMACIST
• Debra Bennett, PMHNP
• Benson Family Medical Group Inc
• Aurora L Benson, D.O.
• Eola Anne Bentley-Force, FNP
• Carolyn Izu Bergmann, D.M.D
• Rainer H. Bergmann, DMD
• Brian Reinard Bergstrom, D.C.
• Roxana Lopez Bernal

• Family Medicine Physician in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.