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Individual

IRENE PE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12665 GARDEN GROVE BLVD, SUITE 606, GARDEN GROVE, CA 92843-1901
(714) 530-5100
(714) 534-9400
Mailing address
12665 GARDEN GROVE BLVD, SUITE 606, GARDEN GROVE, CA 92843-1901
(714) 530-5100
(714) 534-9400

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A49301
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A493010
CA
Enumeration date
02/10/2009
Last updated
02/10/2009
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