Peckson, Louella

Peckson, Louella is an sole proprietor health care provider with primary practice located at 14624 Sherman Way Suite 401, Van Nuys CA 91405-2241. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Peckson, Louella can be contacted via phone (818) 786-1200.

Contact Information

Primary practice address
14624 Sherman Way Suite 401 Van Nuys CA 91405-2241
Fax: (818) 786-1201
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A53093 California

Profile Details

NPI number 1467540021
LBN Legal business name Peckson, Louella
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2006
Last updated Jul 21st, 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 1467540021 NPPES
California MEDICAID 00A530930

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