Individual
SERGIO PENAHERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 W 24TH ST, 1, YUMA, AZ 85364-6298
(928) 344-6450
(928) 344-6480
Mailing address
2400 S AVENUE A, YUMA, AZ 85364-7170
(928) 344-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22887
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167090003
—
AZ
01
—
522352991
TRIWEST HEALTHCARE
AZ
01
—
AZ0721180
BLUE CROSS BLUE SHIELD
AZ
01
—
DC7704
RAILROAD MEDICARE
AZ
Enumeration date
10/12/2006
Last updated
01/03/2025
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