Organization
REBECCA IRENE A PENA D M D A DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA IRENE ALCAZAREN PENA D.M.D. (PRESIDENT)
(562) 920-1726
Entity
Organization
Contact information
Practice address
5445 DEL AMO BLVD, SUITE 103, LAKEWOOD, CA 90712-2760
(562) 920-1726
(562) 920-1728
Mailing address
5445 DEL AMO BLVD, SUITE 103, LAKEWOOD, CA 90712-2760
(562) 920-1726
(562) 920-1728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457368425
NPI TYPE 1
CA
01
—
49181
DENTAL LICENSE
CA
Enumeration date
11/01/2012
Last updated
03/07/2023
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