Provider Demographics
NPI:1306891171
Name:BENONI, MALKA (MD)
Entity type:Individual
Prefix:
First Name:MALKA
Middle Name:
Last Name:BENONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3023 BUNKER HILL ST
Mailing Address - Street 2:SUITE #203
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109
Mailing Address - Country:US
Mailing Address - Phone:858-581-2225
Mailing Address - Fax:858-581-3870
Practice Address - Street 1:3023 BUNKER HILL ST
Practice Address - Street 2:SUITE #203
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109
Practice Address - Country:US
Practice Address - Phone:858-581-2225
Practice Address - Fax:858-581-3870
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35765207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A84810Medicare UPIN