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Individual

MR. PETER SEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
1830 W OLYMPIC BLVD STE 123, LOS ANGELES, CA 90006-3734
(213) 383-9212
Mailing address
1830 W OLYMPIC BLVD STE 123, LOS ANGELES, CA 90006-3734
(213) 383-9212

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224900000X
Mastectomy Fitter
224L00000X
Pedorthist
224P00000X
Prosthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GXC000070
CA
Enumeration date
09/16/2019
Last updated
09/16/2019
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