Juan Carlos Pena, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A79366 Issued in CA

Practice address

445 E Anaheim St Ste H
Wilmington, CA 90744-4600

Phone

(310) 518-6146

Fax

(877) 469-1428

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: juan.pena.p1@direct.fhccgla.nextgenshare.com

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

• Central Health Plan of California, Inc.

  • Health Maintenance Organization
  • Diamond Bar, CA
  • NPI 1386714772
  Medicare reassignment NPD
• Molina Care Connections, LLC.

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  OH

  Medicare reassignment NPD
• Molina Healthcare of California

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment
• Universal Care

  • Pediatrics Physician
  • Long Beach, CA
  • NPI 1376632877
  NPD
• Joseph M Molina MD Professional Corporation-Southern California

  • Family Medicine Physician
  • Wilmington, CA
  • NPI 1982976692
  NPD (past)
• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1073628202
  NPD (past)
• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1841305075
  NPD (past)
• Molina Medical Centers

  • Family Medicine Physician
  • Colton, CA
  • NPI 1114032448
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1689738189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024302",
            "telephone_number": "562-499-6191",
            "fax_number": "877-469-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E ANAHEIM ST STE H",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444600",
            "telephone_number": "310-518-6146",
            "fax_number": "877-469-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A79366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01272671/DU4032",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A793660",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A793660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gil John Pangelinan
• Melanie Parham
• Eunice Park
• Yvette Marie Parra, RAS
• Vaishali Patel, DDS
• Angel Guillen Perez, MEDICAL DOCTOR
• Personal Space Testing
• Richard M Peters, OD
• Robin Anne Petersen, SUDCCII
• Gam Nguyen Hong Pham, PA-C

• Family Medicine Physician in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.