Provider Demographics
NPI:1992855381
Name:PENA, FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:PENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10277 N 92ND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4564
Mailing Address - Country:US
Mailing Address - Phone:480-609-1444
Mailing Address - Fax:480-609-1359
Practice Address - Street 1:10277 N 92ND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4564
Practice Address - Country:US
Practice Address - Phone:480-609-1444
Practice Address - Fax:480-609-1359
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ012451Medicaid
AZD44359Medicare UPIN
AZ012451Medicaid