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NPI Code Detail

MEDICARE: ALBERT DE LA PENA M.D.

MEDICARE: ALBERT DE LA PENA M.D.
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
1207W00000XOphthalmology PhysicianA26114CA

General Provider Information

NPI Number : 1649295114
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALBERT DE LA PENA M.D.
Provider Business Mailing Address
First Line : 2446 W WHITTIER BLVD
Second Line :
City : MONTEBELLO
State : CA
Zip : 90640-3041
Country : US
Telephone Number : 323-728-5500
Fax Number : 323-728-4408
Provider Business Practice Location Address
First Line : 2446 W WHITTIER BLVD
Second Line :
City : MONTEBELLO
State : CA
Zip : 90640-3041
Country : US
Telephone Number : 323-728-5500
Fax Number : 323-728-4408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 08/16/2007

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Directions to “ ALBERT DE LA PENA M.D.” Practice Location

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