Individual
CHRISTOPHER A PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2677
AR
152W00000X
Optometrist
Primary
OPT.0003255
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29168511
—
CO
01
—
OPT.0003255
CO OPTOMETRY LICENSE
CO
Enumeration date
08/15/2012
Last updated
06/12/2019
Update your record
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