Chanthol Pen, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20656 Issued in CA

Practice address

822 East Avenue K
Lancaster, CA 93535-5938

Phone

(661) 579-9760

Fax

(661) 579-9765

NPI assigned

Dec 14, 2009

Last updated

Aug 28, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of Los AngelesGroup PAC ID 1850296534, shared by 7 NPIs, 395 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lac/Olive View-UCLA Medical Center Hospital, Sylmar, CA, CCN 050040

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Los Angeles

  dba Martin Luther King, Jr. Outpatient Center

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1780877613
  Medicare reassignment NPD
• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  dba High Desert System

  • Clinic/Center
  • Lancaster, CA
  • NPI 1205354370
  NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles Auditor Controller

  dba High Desert Regional Health Center

  • Clinic/Center
  • Lancaster, CA
  • NPI 1366453045
  NPD
• FHMC Group Inc

  • Primary Care Clinic/Center
  • Arleta, CA
  • NPI 1790306074
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Los Angeles

  dba Los Angeles County Olive View-UCLA Medical Center

  • General Acute Care Hospital
  • Sylmar, CA
  • NPI 1134143415
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1649509134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 E PALMDALE BLVD",
            "address_2": "SUITE",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504037",
            "telephone_number": "661-942-2391",
            "fax_number": "661-575-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 EAST AVENUE K",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935355938",
            "telephone_number": "661-579-9760",
            "fax_number": "661-579-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEN",
        "first_name": "CHANTHOL",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9232475",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Janess Pedraza
• Tia Pedretti
• Emmanuela Leah Morgan Peer, RADT
• Danielle Pegula
• Crystal Lynn Pelletier
• Fernando Pena Jr.
• Guadalupe Gabriela Pena
• Jacqueline Ruby Pena
• Orlando I Pena, D.O.
• Cijerra N Penkey

• Family Nurse Practitioner in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.