Individual
BRIAN THOMAS PEKAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9000
Mailing address
47 PENNY LN STE 1, WATSONVILLE, CA 95076-6055
(831) 728-8844
(831) 763-1001
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
278
AL
213E00000X
Podiatrist
E5177
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
278
AL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
304113
LA
213ES0103X
Foot & Ankle Surgery Podiatrist
36 003501
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051556220
—
AL
01
—
1563848
MEDICAID GROUP
OH
01
—
CH5179
RR MEDICARE GROUP
OH
Enumeration date
06/05/2006
Last updated
07/23/2024
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