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Individual
HENRY PENG
Active
Individual
HENRY PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A95408
CA
2084S0010X
Sports Medicine (Psychiatry & Neurology) Physician
A95408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A95408
STATE LICENSE
CA
Enumeration date
01/08/2007
Last updated
09/23/2011
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