Kennedy, Peter Samuel

Kennedy, Peter Samuel is an sole proprietor health care provider with primary practice located at 201 S Alvarado St Suite 110, Los Angeles CA 90057-2320. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Kennedy, Peter Samuel can be contacted via phone (213) 484-6474.

Contact Information

Primary practice address
201 S Alvarado St Suite 110 Los Angeles CA 90057-2320
Phone: (213) 484-6474
Fax: (213) 484-8470
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X C38037 California

Profile Details

NPI number 1104882810
LBN Legal business name Kennedy, Peter Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 21st, 2006
Last updated May 6th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104882810 NPPES
California MEDICAID 00380370

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