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Organization
PETER D. SLISKOVICH, MD, INC.
Active
Organization
PETER D. SLISKOVICH, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER DAN SLISKOVICH M.D. (OWNER/PRESIDENT)
(310) 833-2461
Entity
Organization
Contact information
Practice address
1360 W 6TH ST, SUITE 120 WEST BUILDING, SAN PEDRO, CA 90732-3514
(310) 833-2461
(310) 833-6342
Mailing address
1360 W 6TH ST, SUITE 120 WEST BUILDING, SAN PEDRO, CA 90732-3514
(310) 833-2461
(310) 833-6342
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G42414
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G424140
—
CA
01
—
G42414
MEDICARE PTAN
CA
Enumeration date
11/06/2010
Last updated
11/06/2010
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