Pena, Gilbert N/A
Pena, Gilbert N/A is an individual health care provider with primary practice located at 1205 Renaissance Pkwy Ste 240 , Rialto CA 92376-2418. He recently has only one registered license in Dental Providers / Dental Assistant, which is considered as his primary health care specialty. Pena, Gilbert N/A can be contacted via phone (909) 253-0490.Contact Information
Primary practice address
1205 Renaissance Pkwy Ste 240
Rialto CA 92376-2418
Phone: (909) 253-0490
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Assistant | 126800000X | RDA93312 | California |
Profile Details
| NPI number | 1467090514 |
|---|---|
| LBN Legal business name | Pena, Gilbert N/A |
| Credentials | Registered Dental Assistant (RDA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2019 |
| Last updated | Dec 20th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467090514 | NPPES |
| California | MEDICAID | RDA93312 |
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