Individual
JEFFREY PENTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5755 YORKSHIRE AVE, LA MESA, CA 91942-2816
(619) 307-1607
Mailing address
5755 YORKSHIRE AVE, LA MESA, CA 91942-2816
(619) 307-1607
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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