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Nicholas Penner, MD
Student in an Organized Health Care Education/Training Program in San Diego, California
NPI 1104158104

Nicholas Penner is a Student in an Organized Health Care Education/Training Program based in San Diego, CA. Nicholas Penner practices in San Diego, CA and has the professional credentials of MD. The NPI Number for Nicholas Penner is 1104158104 and holds a License No. (California).

The current practice location address for Nicholas Penner is 402 Dickinson St, San Diego, CA and can be reached out via phone at 619-543-6529.

Location: 402 Dickinson St, San Diego, CA, 92101-2885
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104158104
Provider Name
Nicholas Penner
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
402 Dickinson St, San Diego, CA, 92101-2885
Phone Number
619-543-6529
Fax Number
Provider Enumeration Date
02/02/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
402 Dickinson St
City
San Diego
State
California
Zip
92103-6902
Phone Number
619-543-6529
Fax Number
person
Provider Business Mailing Address Details
Address
402 Dickinson St
City
San Diego
State
California
Zip
92103-6902
Phone Number
619-543-6529
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
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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