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Individual

PETER F. CROOKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1510 SAN PABLO ST, SUITE 514, LOS ANGELES, CA 90033
(323) 442-5910
(323) 442-6798
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-9062

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A55377
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000F40030C29
CAL OPTIMA PIN
CA
01
00A553770
BLUE SHIELD PIN
CA
05
00A553770
CA
01
020039942
MEDICARE RAILROAD PIN
CA
Enumeration date
06/19/2006
Last updated
05/22/2018
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