Pena, Juan Carlos

Pena, Juan Carlos is an individual health care provider with primary practice located at 445 E Anaheim St Ste H , Wilmington CA 90744-4600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pena, Juan Carlos can be contacted via phone (310) 518-6146.

Contact Information

Primary practice address
445 E Anaheim St Ste H Wilmington CA 90744-4600
Phone: (310) 518-6146
Fax: (877) 469-1428
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A79366 California

Profile Details

NPI number 1689738189
LBN Legal business name Pena, Juan Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2006
Last updated Apr 15th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689738189 NPPES
California Other P01272671/DU4032 RAILROAD MEDICARE
California MEDICAID 00A793660 RAILROAD MEDICARE
California Other 00A793660 RAILROAD MEDICARE

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