| NPI | 1720196538 |
|---|---|
| Other Name | PROVIDERS RICHARD PENMAN III EDDIE CHONG |
| Entity Type | Organization |
| Authorized Contact | TRACY JO ANDERSON Manager 951-302-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |