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
Phone: (310) 657-6363
Fax: (310) 652-5785
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538185376 | NPPES |
California | MEDICAID | B38348-01 |
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