Provider Demographics
NPI:1205081205
Name:BENNETTS, GENE ALDRICH (MD)
Entity type:Individual
Prefix:DR
First Name:GENE
Middle Name:ALDRICH
Last Name:BENNETTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 LUPINE HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3819
Mailing Address - Country:US
Mailing Address - Phone:707-258-1845
Mailing Address - Fax:707-258-8394
Practice Address - Street 1:10 LUPINE HILL ROAD
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3819
Practice Address - Country:US
Practice Address - Phone:707-258-1845
Practice Address - Fax:707-258-8394
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG284882080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology