Individual
DR. PENNY ROBILLARD VANDESTREEK
Active
Individual
DR. PENNY ROBILLARD VANDESTREEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
20A6232
CA
207UN0901X
Nuclear Cardiology Physician
20A6232
CA
207UN0902X
Nuclear Imaging & Therapy Physician
20A6232
CA
207UN0903X
In Vivo & In Vitro Nuclear Medicine Physician
20A6232
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX62320
—
CA
01
—
P00017739
RAILROAD MEDICARE
CA
Enumeration date
06/09/2006
Last updated
11/17/2023
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