Individual
DR. GARY NEIL PESSELNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1512 ARROYO VIEW ST, THOUSAND OAKS, CA 91320-6581
(818) 383-2005
Mailing address
1512 ARROYO VIEW ST, THOUSAND OAKS, CA 91320-6581
(818) 383-2005
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G24943
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G24943
STATE LICENSE
CA
01
—
WG 24943A
PIN
CA
Enumeration date
07/12/2006
Last updated
07/31/2019
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