1427617596 NPI number — KARMA DOCTORS & ASSOCIATES, P.C.

Table of content: DR. CHRISTOPHER RYAN BENTON DO (NPI 1720508260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427617596 NPI number — KARMA DOCTORS & ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KARMA DOCTORS & ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427617596
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17853 SANTIAGO BLVD STE 107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VILLA PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92861-4199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-685-2022
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3822 CAMPUS DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92660-2609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-444-5214
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/11/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SUNDER
Authorized Official First Name:
RAJAGOPAL
Authorized Official Middle Name:
KEERTHY
Authorized Official Title or Position:
FOUNDER
Authorized Official Telephone Number:
951-529-5518

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)