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Benjamin Anthony Corona

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

1200 N State St, Clinic Tower, Suite A7d, Los Angeles, CA 90033-1029

PECOS Enrollment

This provider is enrolled in PECOS as BENJAMIN CORONA.

Based on the most recent information from CMS, provider Benjamin Anthony Corona is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1477134344
Provider Type
Individual
Full Name
Corona, Benjamin Anthony
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
4/21/2021
Last Updated
5/10/2023

Contact Information

Practice Location

1200 N State St, Clinic Tower, Suite A7d, Los Angeles, CA 90033-1029

(323) 409-5555

Unlisted Fax

Mailing Location

2010 Zonal Ave # 1p10, Los Angeles, CA 90033-1026

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License A184733 California
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License PTL7782 California
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Benjamin Anthony Corona

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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