Active NPI
Ralph Charles Pene
- Pediatric Hematology & Oncology Physician
- San Diego, CA
National Provider Identifier
1306900022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- MD00026624
- Practice address
- 34800 Bob Wilson Drive
San Diego, CA 92134 - Phone
- (619) 532-6400
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Hematology & Oncology Physician | 2080P0207X | MD00026624 | WA | Primary |
Addresses
Primary practice location
34800 Bob Wilson Drive
San Diego, CA 92134
Mailing address
14679 Ibex CT
San Diego, CA 92129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00026624 | WA | MD | Pediatric Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306900022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14679 IBEX CT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DRIVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92134",
"telephone_number": "619-532-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENE",
"first_name": "RALPH",
"middle_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "WA",
"license": "MD00026624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.