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Organization
JACOB B PELTA MD
Active
Organization
JACOB B PELTA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB B PELTA MD (OWNER)
(323) 653-6166
Entity
Organization
Contact information
Practice address
6360 WILSHIRE BLVD, SUITE # 501, LOS ANGELES, CA 90048-5603
(323) 653-6166
(323) 653-6171
Mailing address
6360 WILSHIRE BLVD, SUITE # 501, LOS ANGELES, CA 90048-5603
(323) 656-3616
(323) 653-6171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G23606
CA
207RR0500X
Rheumatology Physician
G23606
CA
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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