Individual
SERGIO PENAHERRERA
Active
Individual
SERGIO PENAHERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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