Doctor Name: | DR. BENEDICTO GAONA MASILUNGAN |
NPI Number: | 1578617205 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A053680 |
Business Practice Address: | 509 So Cedros Ave #a Solana Beach, CA - 92075 |
Business Phone Number: | 8583504414 |
Business Fax Number: | 8585190002 |
Mailing Address: | 509 So Cedros Ave, #a SOLANA BEACH |
State: | CA |
Postal Code: | 92075 |
Phone Number: | 8583504414 |
Fax Number: | 8585190002 |
NPI Enumeration Date: | 01/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A053680 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |