Peckham, John J.

Peckham, John J. is an individual health care provider with primary practice located at 5555 Grossmont Center Dr , La Mesa CA 91942-3019. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Peckham, John J. can be contacted via phone (619) 460-5111.

Contact Information

Primary practice address
5555 Grossmont Center Dr La Mesa CA 91942-3019
Fax: (619) 460-7815
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X A61160 California
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD217563 Oregon
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 101666-875 Wisconsin

Profile Details

NPI number 1538206131
LBN Legal business name Peckham, John J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Apr 29th, 2024 - about 7 months 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 1538206131 NPPES
California MEDICAID 00A611600

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