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DEVAUGHN PEACE MD NPI 1831103779


NPI Information

NPI: 1831103779
Provider Name: DEVAUGHN PEACE, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 05D0928544

Address:
4326 S WESTERN AVE
LOS ANGELES, CA
ZIP 90062
Phone: (213) 299-9914
Get Directions

Devaughn Peace, MD is a pediatrics in Los Angeles, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Devaughn Peace, MD NPI is 1831103779. 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:

4326 S WESTERN AVE
LOS ANGELES, CA
ZIP 90062-648
Phone: (213) 299-9914
Fax: (213) 292-3254

The CLIA number assigned to this NPI record is 05D0928544 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 7/9/2007.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsG29868CALIFORNIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G29868MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE
200G298680MEDICAIDCALIFORNIA

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: 5/5/2024

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