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Individual

MICHAEL PAUL PENNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
13661 CALIMESA BLVD STE 6, YUCAIPA, CA 92399-2370
(909) 699-2539
Mailing address
13661 CALIMESA BLVD STE 6, YUCAIPA, CA 92399-2370
(909) 699-2539

Taxonomy

Speciality
Code
Description
License number
State
146L00000X
Paramedic
P30227
CA
163WE0003X
Emergency Registered Nurse
Primary
95170352
CA

Other

Enumeration date
09/19/2024
Last updated
09/19/2024
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