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General NPI Number Information
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NPI Number | 1861137929
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Entity Type | Individual
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Provider Name | CINDY PENG
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Gender | Female
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 132 N SWALL DR UNIT 102
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City | LOS ANGELES
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State | CA
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Zip | 90048-3037
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Country | US
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Telephone | 516-993-8583
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Fax |
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Provider Business Mailing Address
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Address Line | 132 N SWALL DR UNIT 102
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City | LOS ANGELES
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State | CA
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Zip | 90048-3037
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Country | US
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Telephone | 516-993-8583
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA59258
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License Number State | CA
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