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Individual

ANDRES PENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6555 COYLE AVE, CARMICHAEL, CA 95608-0302
(916) 536-2408
Mailing address
6555 COYLE AVE, CARMICHAEL, CA 95608-0302
(916) 536-2408

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A86087
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A860870
CA
Enumeration date
11/15/2006
Last updated
02/24/2012
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