Organization · NPI-2

A De La Pena M D A Medical Group INC

Ophthalmology · Los Angeles, CA

NPI number1962412643
StatusActive
Last updated in NPPESFeb 25, 2013

Details

NPI
1962412643
Entity type
Organization (NPI-2)
Legal business name
A De La Pena M D A Medical Group INC
Organization subpart
No
Enumeration date
Aug 8, 2006
Last updated
Feb 25, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X Ophthalmology––Yes
152W00000X Optometrist––

Other names

  • A. De La Pena MD, Amg, INC. (Doing Business As)

Practice location

139 S Alvarado St
Los Angeles, CA 90057-2201

Phone 213-484-0170 · Fax 213-484-0246

Mailing address

2446 W Whittier Blvd
Montebello, CA 90640-3041

Phone 323-728-5500 · Fax 323-728-4408

Authorized official

Albert De La Pena
Owner
3237285500

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