Organization
LOUELLA PECKSON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUELLA L PECKSON M.D. (PRESIDENT)
(818) 786-1200
Entity
Organization
Contact information
Practice address
14624 SHERMAN WAY, SUITE 401, VAN NUYS, CA 91405-2241
(818) 786-1200
(818) 786-1201
Mailing address
14624 SHERMAN WAY, SUITE 401, VAN NUYS, CA 91405-2241
(818) 786-1200
(818) 786-1201
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A53093
—
CA
Enumeration date
06/27/2011
Last updated
06/27/2011
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