Individual
PETER PAUL PENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11175 CAMPUS ST STE 21121, LOMA LINDA, CA 92350-1700
(909) 558-5959
Mailing address
33814 CANSLER WAY, YUCAIPA, CA 92399-6987
(914) 980-5001
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60228
CA
Other
Enumeration date
08/17/2021
Last updated
07/11/2023
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