Provider Demographics
NPI:1366621583
Name:SANTOS, BENJAMIN S JR (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:S
Last Name:SANTOS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2355 WESTWOOD BLVD # 144
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2109
Mailing Address - Country:US
Mailing Address - Phone:310-775-0559
Mailing Address - Fax:
Practice Address - Street 1:8700 BEVERLY BLVD # 1103
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-8780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA98885207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACC733YMedicare PIN