# A DE LA PENA M D A MEDICAL GROUP INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** A. DE LA PENA MD, AMG, INC.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871503557
- **Authorized official:** ALBERT DE LA PENA M.D. (OWNER)
- **Authorized official phone:** (323) 728-5500

## Contact information

- **Practice address:** 2446 W WHITTIER BLVD, MONTEBELLO, CA 90640-3041
- **Practice address phone:** (323) 728-5500
- **Practice address fax:** (323) 728-4408
- **Mailing address:** 2446 W WHITTIER BLVD, MONTEBELLO, CA 90640-3041
- **Mailing address phone:** (323) 728-5500
- **Mailing address fax:** (323) 728-4408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 07/31/2009