Peck, Leon Robert

Peck, Leon Robert is an sole proprietor health care provider with primary practice located at 8500 Wilshire Blvd Suite 815, Beverly Hills CA 90211-3121. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Peck, Leon Robert can be contacted via phone (310) 657-6363.

Contact Information

Primary practice address
8500 Wilshire Blvd Suite 815 Beverly Hills CA 90211-3121
Fax: (310) 652-5785
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 38348 California
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 38348 California

Profile Details

NPI number 1538185376
LBN Legal business name Peck, Leon Robert
Credentials DDS, PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2006
Last updated Nov 20th, 2009 - about 15 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 1538185376 NPPES
California MEDICAID B38348-01

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