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PETER SAMUEL KENNEDY MD NPI 1104882810


NPI Information

NPI: 1104882810
Provider Name: PETER SAMUEL KENNEDY, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Address:
201 S ALVARADO ST
SUITE 110
LOS ANGELES, CA
ZIP 90057
Phone: (213) 484-6474
Get Directions

Peter Samuel Kennedy, MD is a hematology and oncology internal medicine in Los Angeles, CA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Peter Samuel Kennedy, MD NPI is 1104882810. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

201 S ALVARADO ST
SUITE 110
LOS ANGELES, CA
ZIP 90057-320
Phone: (213) 484-6474
Fax: (213) 484-8470

The enumeration date for this NPI number is 4/21/2006 and was last updated on 5/6/2010.


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
1207RH0003XInternal MedicineHematology & OncologyC38037CALIFORNIAYes

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
100380370MEDICAIDCALIFORNIA
2WC38037TMEDICARE PINCALIFORNIA
3A36824MEDICARE UPINCALIFORNIA

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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