Individual
DR. PEYTON LUBBOCK NISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-7900
Mailing address
5026 ROSEWOOD AVE APT 505, LOS ANGELES, CA 90004-1796
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
390200000X
CA
Other
Enumeration date
04/28/2020
Last updated
05/07/2020
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