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1245439157
PENNY LANE MAKABENTA
FULLERTON, CA
NPI
1245439157
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA18214)
Enumeration Date
2007-07-12
Last Update Date
2007-07-12
Business Address
-- PENNY LANE MAKABENTA PA
2720 N HARBOR BLVD SUITE 130
FULLERTON, CA 92835-2609
Phone number: 714-449-6230
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Mailing Address
-- PENNY LANE MAKABENTA PA
DEPT LA21190
PASADENA, CA 91185-1190
Phone number: 714-449-4800
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