# JOSHUA PENGSON, M.D. INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346886140
- **Authorized official:** DR. JOSHUA PENGSON MD (CEO)
- **Authorized official phone:** (951) 243-6460

## Contact information

- **Practice address:** 23180 HEMLOCK AVE STE 201, MORENO VALLEY, CA 92557-8001
- **Practice address phone:** (951) 243-6460
- **Mailing address:** 23180 HEMLOCK AVE STE 201, MORENO VALLEY, CA 92557-8001
- **Mailing address phone:** (951) 243-6460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/27/2019
- **Last updated:** 12/13/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1578925855 | — | CA |