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Organization

PETER P. KOENIG, M.D., INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER P KOENIG M.D. (5 PERCET OR MORE OWNERSHIP INTEREST)
(818) 528-1222
Entity
Organization

Contact information

Practice address
4940 VAN NUYS BLVD., SUITE 200, SHERMAN OAKS, CA 91403-1741
(818) 528-1222
(828) 528-1225
Mailing address
4940 VAN NUYS BLVD., SUITE 200, SHERMAN OAKS, CA 91403-1741
(818) 528-1222
(828) 528-1225

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A23943
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A23943
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063462521
NPI
CA
Enumeration date
05/12/2006
Last updated
01/11/2011
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