Doctor Name: | ADELA P PENA |
NPI Number: | 1932281573 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | A37943 |
Business Practice Address: | 50 S Anaheim Blvd #96 Anaheim, CA - 92805 |
Business Phone Number: | 7147725520 |
Business Fax Number: | |
Mailing Address: | 50 S Anaheim Blvd, #96 ANAHEIM |
State: | CA |
Postal Code: | 92805 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A37943 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |