Provider Demographics
NPI:1073179917
Name:PENG, ANNIE YU-HUEY (DO)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:YU-HUEY
Last Name:PENG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 S CHERRYBELL STRA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-1907
Mailing Address - Country:US
Mailing Address - Phone:650-224-5915
Mailing Address - Fax:
Practice Address - Street 1:1230 S CHERRYBELL STRA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-1907
Practice Address - Country:US
Practice Address - Phone:520-670-3909
Practice Address - Fax:520-309-2560
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ009675207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine