Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Benton Real Stout, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1649508334

Benton Real Stout, PHYSICIANASSISTANT is a Physician Assistant in Riverside, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2009
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Practice location Address checks out

1850 Spring Garden St
Riverside, CA 92507-2050
Phone: (951) 544-9589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA20699 (CA)

Record details

NPI number1649508334
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedNovember 18, 2009
Last updated in NPPESNovember 18, 2009

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