Individual
RENEE JOHANNAH PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, SUITE 550, LOS ANGELES, CA 90024-0000
(310) 206-6688
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 301-8708
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A103316
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1033160
—
CA
Enumeration date
05/05/2008
Last updated
12/04/2008
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