Individual
CHARLES PENICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
27335 TOURNEY RD STE 100, SANTA CLARITA, CA 91355-2200
(661) 338-5983
Mailing address
5655 N GLENWOOD ST STE 105, GARDEN CITY, ID 83714-1831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-15738
ID
Other
Enumeration date
04/28/2015
Last updated
12/05/2024
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