Provider Demographics
NPI:1316194731
Name:BENAVIDEZ, STEVEN
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:BENAVIDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10012 NORWALK BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3362
Mailing Address - Country:US
Mailing Address - Phone:562-942-9625
Mailing Address - Fax:562-942-9695
Practice Address - Street 1:10012 NORWALK BLVD STE 140
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3362
Practice Address - Country:US
Practice Address - Phone:562-942-9625
Practice Address - Fax:562-942-9695
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner