Provider Demographics
NPI:1962622001
Name:FLORES, BENJAMIN HERNANDEZ (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:HERNANDEZ
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HAMILTON AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2010
Mailing Address - Country:US
Mailing Address - Phone:650-330-1636
Mailing Address - Fax:650-330-0420
Practice Address - Street 1:550 HAMILTON AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2010
Practice Address - Country:US
Practice Address - Phone:650-330-1636
Practice Address - Fax:650-330-0420
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0631452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry