Provider Demographics
NPI:1346239704
Name:PENA, CLAUDIA (MD)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:
Last Name:PENA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1770 N ORANGE GROVE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3027
Mailing Address - Country:US
Mailing Address - Phone:909-469-9494
Mailing Address - Fax:909-629-6087
Practice Address - Street 1:1770 N ORANGE GROVE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3027
Practice Address - Country:US
Practice Address - Phone:909-469-9494
Practice Address - Fax:909-629-6087
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA91573207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABP9293250OtherDEA #
CABP9293250OtherDEA #
CAI40992Medicare UPIN