| Doctor Name: | DR. JOSE CALIXTO DE LA PENA |
| NPI Number: | 1154391977 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ME20594 |
| Business Practice Address: | Naval Hospital Cherry Point 4389 Beaufort Rd. Cherry Point, NC - 28533 |
| Business Phone Number: | 2524660182 |
| Business Fax Number: | |
| Mailing Address: | 5205 Bartons Creek Ct, SUFFOLK |
| State: | VA |
| Postal Code: | 234352689 |
| Phone Number: | 7574846901 |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | ME20594 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |