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Individual

DR. MARIO PENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6900 PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9020
(702) 396-7587
Mailing address
6900 PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9020
(702) 396-7587

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8299
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487674123
NV
01
P00853259
RAILROAD MEDICARE
NV
Enumeration date
07/19/2006
Last updated
09/26/2013
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