Provider Demographics
NPI:1316959299
Name:BENJAMIN WOLSZTEJN, MD INC
Entity type:Organization
Organization Name:BENJAMIN WOLSZTEJN, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLSZTEJN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACOG
Authorized Official - Phone:510-581-7666
Mailing Address - Street 1:20130 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5340
Mailing Address - Country:US
Mailing Address - Phone:510-581-7666
Mailing Address - Fax:
Practice Address - Street 1:20130 LAKE CHABOT RD
Practice Address - Street 2:SUITE 306
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5340
Practice Address - Country:US
Practice Address - Phone:510-581-7666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24169207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty