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NPI Code Detail

MEDICARE: JUNE S PENG MD

MEDICARE: JUNE S PENG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086X0206XSurgical Oncology PhysicianMD468184PA
22086X0206XSurgical Oncology Physician191994CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124321252
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUNE S PENG MD
Provider Business Mailing Address
First Line : 1479 YGNACIO VALLEY RD STE 200
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-2954
Country : US
Telephone Number : 925-296-7340
Fax Number :
Provider Business Practice Location Address
First Line : 1479 YGNACIO VALLEY RD STE 200
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-2954
Country : US
Telephone Number : 925-296-7340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2010
Last Update Date : 11/21/2023

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