Individual
PENGSE PO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DR, SAN DIEGO, CA 92134-5000
(781) 244-8817
Mailing address
2496 BAUER RD, SAN DIEGO, CA 92126
(619) 881-9011
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
2083A0100X
Aerospace Medicine Physician
Primary
0102207368
VA
208D00000X
General Practice Physician
20A23397
CA
Other
Enumeration date
03/15/2021
Last updated
10/15/2025
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