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LOUELLA PECKSON M.D. INC. NPI 1144516295


NPI Information

NPI: 1144516295
Provider Name: LOUELLA PECKSON, M.D., INC.
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
14624 SHERMAN WAY
SUITE 401
VAN NUYS, CA
ZIP 91405
Phone: (818) 786-1200
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LOUELLA PECKSON, M.D., INC. is an adolescent medicine pediatrics in Van Nuys, CA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. LOUELLA PECKSON, M.D., INC. NPI is 1144516295. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

14624 SHERMAN WAY
SUITE 401
VAN NUYS, CA
ZIP 91405-241
Phone: (818) 786-1200
Fax: (818) 786-1201

The provider's authorized official is Louella L Peckson .
The authorized official title is President and has the following contact phone number (818) 786-1200.

The enumeration date for this NPI number is 6/27/2011 and was last updated on 6/27/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080A0000XPediatricsAdolescent MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A53093MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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