Provider Demographics
NPI:1730609199
Name:TERRANO, BENJAMIN LOGAN (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LOGAN
Last Name:TERRANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BEN
Other - Middle Name:LOGAN
Other - Last Name:TERRANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC, DACNB, CCEP
Mailing Address - Street 1:3530 CAMINO DEL RIO N STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1745
Mailing Address - Country:US
Mailing Address - Phone:619-785-3688
Mailing Address - Fax:
Practice Address - Street 1:3530 CAMINO DEL RIO N STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1745
Practice Address - Country:US
Practice Address - Phone:619-785-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39950111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology