Individual
JAN R PENVOSE-YI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3998 VISTA WAY STE C, OCEANSIDE, CA 92056-4514
(760) 385-8008
(760) 385-8007
Mailing address
3998 VISTA WAY STE C, OCEANSIDE, CA 92056-4514
(760) 385-8008
(760) 385-8007
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
238705
NY
207V00000X
Obstetrics & Gynecology Physician
Primary
P132992
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027679002
UNIVERA
NY
01
—
000528650003
BCBS
NY
05
—
02780101
—
NY
01
—
0713851
IHA
NY
Enumeration date
09/12/2006
Last updated
04/23/2018
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