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
Phone: (619) 460-5111
Fax: (619) 460-7815
Website:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538206131 | NPPES |
| California | MEDICAID | 00A611600 |
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5555 Grossmont Center Dr , La Mesa CA 91942