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Individual

MARVIN ANTONIO PENA

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
COMDT (CG-1122) US COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(310) 732-7500
Mailing address
COMDT (CG-1122) US COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(310) 732-7500

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
01/31/2006
Last updated
07/08/2007
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