| Doctor Name: | DR. HAI-EN PENG |
| NPI Number: | 1033305677 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | E4368 |
| Business Practice Address: | 425 Haaland Dr Suite 201 Thousand Oaks, CA - 913615229 |
| Business Phone Number: | 8054962383 |
| Business Fax Number: | 8054962387 |
| Mailing Address: | 425 Haaland Dr, Suite 201 THOUSAND OAKS |
| State: | CA |
| Postal Code: | 913615229 |
| Phone Number: | 8054962383 |
| Fax Number: | 8054962387 |
| NPI Enumeration Date: | 09/18/2007 |
| NPI Last Update Date: | 05/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E4368 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |