BROADWAY MEDICAL CLINIC - NPI 1275936270 - Internal Medicine in El Cajon, CA

Q: What is Jimi O. Benson MD., Inc's NPI number?

The NPI number for Jimi O. Benson MD., Inc is 1275936270. It was assigned to this organization in the NPPES registry on October 3, 2014.

Q: What is Jimi O. Benson MD., Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

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About Broadway Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROADWAY MEDICAL CLINIC (NPI 1275936270) is a healthcare organization registered as an internal medicine in El Cajon, California and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through October 20, 2026 and lists Jimi Ola Benson, President, as its authorized official.

NPPES Registry Identity

NPI1275936270

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameJIMI O. BENSON MD., INC

Location Address1351 BROADWAYEl Cajon, CA 92021-5811

Mailing Address1351 BroadwayEl Cajon, CA 92021-5811 · (619) 383-6703 · Fax (866) 473-3324

Phone(619) 383-6703

Fax(866) 473-3324

Organization SubpartNo

Authorized OfficialJimi Ola BensonPresident · (301) 466-1078

Enumeration DateOctober 3, 2014

Last NPPES UpdateFebruary 7, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 7, 2022

✔ NPI 1275936270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A116611

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1351 BROADWAY, El Cajon, CA 92021

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Other Names 1

Doing Business AsBroadway Medical Clinic

Other Identifiers 2

Medicaid1275936270CA

Medicaid1477751667CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2197090

Broadway Medical Clinic · El Cajon, CA

Active · expires Oct 20, 2026

CLIA Number05D2197090

Laboratory TypePhysician Office

Certificate Effective DateOctober 21, 2024

Certificate Expiration DateOctober 20, 2026

Laboratory DirectorJimi Benson

Laboratory Phone(301) 466-1078

Laboratory LocationBroadway Medical Clinic1351 Broadway, El Cajon, CA 92021

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MASSANU ARISBE SIRLEAF ARNP

Nurse Practitioner (Acute Care)