Doctor Name: | ROCELIOUS MARQUIS BENNETT |
NPI Number: | 1518167253 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | RHT86834 |
Business Practice Address: | 13550 Wilmot St Moreno Valley, CA - 925558233 |
Business Phone Number: | 9098155881 |
Business Fax Number: | |
Mailing Address: | 13550 Wilmot St, MORENO VALLEY |
State: | CA |
Postal Code: | 925558233 |
Phone Number: | 9098155881 |
Fax Number: | |
NPI Enumeration Date: | 07/20/2007 |
NPI Last Update Date: | 07/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | RHT86834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |