Organization
NICOLAS DE LA PENA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLAS R DELA PENA MD (PRESIDENT)
(209) 722-1205
Entity
Organization
Contact information
Practice address
3389 G ST, SUITE A, MERCED, CA 95340-0981
(209) 722-1205
(209) 722-7833
Mailing address
3389 G ST, SUITE A, MERCED, CA 95340-0981
(209) 722-1205
(209) 722-7833
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
A61619
CA
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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