BENTON REAL STOUT

RIVERSIDE, CA
NPI1649508334
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  PA20699)
Enumeration Date2009-11-18
Last Update Date2009-11-18
Business Address
-- BENTON REAL STOUT Physician Assistant
1850 SPRING GARDEN ST
RIVERSIDE, CA 92507-2050
Phone number: 951-544-9589
Mailing Address
-- BENTON REAL STOUT Physician Assistant
1850 SPRING GARDEN ST
RIVERSIDE, CA 92507-2050
Phone number: 951-544-9589
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