Individual
PETER J CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 N BEDFORD DRIVE, SUITE 101, BEVERLY HILLS, CA 90210-4324
(310) 274-9205
(310) 274-7229
Mailing address
450 N BEDFORD DRIVE, SUITE 101, BEVERLY HILLS, CA 90210-4324
(310) 274-9205
(310) 274-7229
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G55677
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G556770
—
CA
01
—
GR0007690
MEDICAID GROUP
CA
Enumeration date
08/30/2006
Last updated
07/08/2007
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