| Jose R Pena Md Pc | |
|
374 H St Suite 201 Chula Vista CA 91910-5547 | |
| (619) 691-1766 | |
| (619) 691-1767 |
| Full Name | Jose R Pena Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 374 H St, Chula Vista, California |
| Authorized Official Name and Position | Jose R. Pena (OWNER) |
| Authorized Official Contact | 6196911766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jose R Pena Md Pc Po Box 1770 La Mesa CA 91944-1770 Ph: (619) 464-1165 | Jose R Pena Md Pc 374 H St Suite 201 Chula Vista CA 91910-5547 Ph: (619) 691-1766 |
| NPI Number | 1508883356 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 01/11/2012 |
| Medicare PECOS PAC ID | 3375667991 |
|---|---|
| Medicare Enrollment ID | O20100902000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508883356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jose Rafael Pena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437170008 PECOS PAC ID: 5698668739 Enrollment ID: I20040203001136 |
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