DR. RAYMOND PENG


Address: 6540 Lusk Blvd Ste C159, San Diego, CA 92121-2684
Phone: 8588889683

DR. RAYMOND PENG (NPI# 1003123662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003123662
Entity Type Individual
Full Name DR. RAYMOND PENG
Credential PSYD
Practice Address 6540 Lusk Blvd Ste C159
San Diego
CA 92121-2684
Practice Telephone 8588889683
Mailing Telephone 8588889683
Enumeration Date 2010-09-02
Last Update Date 2019-07-10
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
30157 CA Behavioral Health & Social Service Providers

Office Location

Street Address 6540 LUSK BLVD STE C159
City SAN DIEGO
State CA
Zip Code 92121-2684

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1396212023 Paul William Randolph Psychologist 727 Robinson Ave Apt D, San Diego, CA 92103-4364 2018-10-31
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Competitor

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City SAN DIEGO
Zip Code 92121

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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