# KEVIN J. PELTON MD, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679771703
- **Authorized official:** DR. KEVIN JEFFREY PELTON MD (DIRECTOR)
- **Authorized official phone:** (323) 264-7600

## Contact information

- **Practice address:** 1700 E CESAR E CHAVEZ AVE, SUITE 2200, LOS ANGELES, CA 90033-2424
- **Practice address phone:** (323) 264-7600
- **Practice address fax:** (323) 261-8027
- **Mailing address:** 1700 E CESAR E CHAVEZ AVE, SUITE 2200, LOS ANGELES, CA 90033-2424
- **Mailing address phone:** (323) 264-7600
- **Mailing address fax:** (323) 261-8027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 171100000X | Acupuncturist | — | NULL | — |
| 171100000X | Acupuncturist | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | — | NULL | — |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |

## Other

- **Enumeration date:** 07/10/2007
- **Last updated:** 05/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1033282637 | IND NPI | CA |