Individual
BRENT MICHAEL PENNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 S HALCYON RD, ARROYO GRANDE, CA 93420
(805) 489-4261
Mailing address
PO BOX 324, DANVILLE, CA 94526-0324
(925) 820-4230
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A153934
CA
Other
Enumeration date
05/21/2013
Last updated
05/17/2018
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