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1104158104
NICHOLAS PENNER
SAN DIEGO, CA
NPI
1104158104
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2010-02-02
Last Update Date
2010-02-02
Business Address
-- NICHOLAS PENNER M.D.
402 DICKINSON ST SUITE 380
SAN DIEGO, CA 92103-6902
Phone number: 619-543-6529
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Mailing Address
-- NICHOLAS PENNER M.D.
855 BEECH ST APT 322
SAN DIEGO, CA 92101-2885
Phone number:
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