Provider Demographics
NPI:1366464901
Name:PENA-ROBLES, KYOKO CHIEMI (MD, MPH)
Entity Type:Individual
Prefix:
First Name:KYOKO
Middle Name:CHIEMI
Last Name:PENA-ROBLES
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:KYOKO
Other - Middle Name:CHIEMI
Other - Last Name:PENA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7524 MONTEREY ST.
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020
Mailing Address - Country:US
Mailing Address - Phone:408-848-9400
Mailing Address - Fax:
Practice Address - Street 1:7526 MONTEREY ST
Practice Address - Street 2:GARDNER HEALTH CENTER-GILORY
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-5826
Practice Address - Country:US
Practice Address - Phone:408-848-9400
Practice Address - Fax:408-848-9464
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine