Provider Demographics
NPI:1801053699
Name:PENG, DEBBIE HWA-YUN (MD)
Entity type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:HWA-YUN
Last Name:PENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S CHEVY CHASE DR
Mailing Address - Street 2:#20
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4431
Mailing Address - Country:US
Mailing Address - Phone:818-637-7980
Mailing Address - Fax:
Practice Address - Street 1:1500 S CENTRAL AVE
Practice Address - Street 2:#100
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2530
Practice Address - Country:US
Practice Address - Phone:818-637-7980
Practice Address - Fax:818-637-7985
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108741208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics