Makabenta, Penny Lane

Makabenta, Penny Lane is an individual health care provider with primary practice located at 2720 N Harbor Blvd Suite 130, Fullerton CA 92835-2609. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Makabenta, Penny Lane can be contacted via phone (714) 449-6230.

Contact Information

Primary practice address
2720 N Harbor Blvd Suite 130 Fullerton CA 92835-2609
Phone: (714) 449-6230
Fax: (714) 449-1773
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA18214 California

Profile Details

NPI number 1245439157
LBN Legal business name Makabenta, Penny Lane
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2007
Last updated Jul 12th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245439157 NPPES
California Other PA18214 LICENSE

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