Individual
DR. KELLY CAROL PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
34800 BOB WILSON DRIVE, EMERGENCY MEDICINE DEPARTMENT, SAN DIEGO, CA 92134-0001
(619) 532-6400
Mailing address
34800 BOB WILSON DRIVE, EMERGENCY MEDICINE DEPARTMENT, SAN DIEGO, CA 92134-0001
(619) 532-6400
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0102203540
VA
207P00000X
Emergency Medicine Physician
Primary
0102203540
VA
Other
Enumeration date
02/12/2012
Last updated
07/30/2026
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