Individual provider · Type 1 NPI

Nicholas Penner, MD

Student in an Organized Health Care Education/Training Program · San Diego, CA

NPI number 1104158104 Active

Practice location

402 Dickinson St, Suite 380
San Diego, CA 92103-6902

Call (619) 543-6529 Map

Mailing address

855 Beech St, Apt 322
San Diego, CA 92101-2885

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104158104

Nicholas Penner, MD's National Provider Identifier is 1104158104, issued on Feb 2, 2010. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Diego, CA. The record was last updated on Feb 2, 2010.