Individual
DR. PETER JAN GEISELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 SAN PABLO ST, SUITE 1000, LOS ANGELES, CA 90033-5310
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5100
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A42608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A426080
BLUE SHIELD
CA
05
—
00A426080
—
CA
01
—
1356390009
GROUP NPI
CA
01
—
1902846306
GROUP NPI
CA
01
—
440000636
RAILROAD MEDICARE
CA
01
—
CE1617
GROUP RAILROAD MEDICARE
CA
01
—
GR0016910
GROUP MEDICAID PIN
CA
01
—
GR0100430
GROUP MEDICAL
CA
01
—
W11675
GROUP MEDICARE PIN
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
06/25/2006
Last updated
10/25/2014
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