Individual
DR. ANTONIO PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 203, PORTLAND, OR 97213-2991
(503) 230-9224
(503) 230-9201
Mailing address
5050 NE HOYT ST, SUITE 203, PORTLAND, OR 97213-2991
(503) 230-9224
(503) 230-9201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
166613
OR
207R00000X
Internal Medicine Physician
22541
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168949
—
AZ
Enumeration date
01/08/2007
Last updated
01/13/2015
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