Individual
PEONY PAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 UCLA MEDICAL PLAZA SUITE 425, LOS ANGELES, CA 90095-2903
(310) 794-1195
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A153936
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2016
Last updated
10/07/2020
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