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NPI Code Detail

MEDICARE: DR. PETER H PAK M.D.

MEDICARE: DR. PETER H PAK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianG84741CA
2207RA0001XAdvanced Heart Failure and Transplant Cardiology PhysicianG84741CA

General Provider Information

NPI Number : 1205833811
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER H PAK M.D.
Provider Business Mailing Address
First Line : 2001 SANTA MONICA BLVD
Second Line : SUITE 280W
City : SANTA MONICA
State : CA
Zip : 90404-2102
Country : US
Telephone Number : 310-829-7678
Fax Number : 310-829-6889
Provider Business Practice Location Address
First Line : 2001 SANTA MONICA BLVD STE 280W
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2172
Country : US
Telephone Number : 310-829-7678
Fax Number : 310-829-6889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2005
Last Update Date : 11/28/2022

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Directions to “ DR. PETER H PAK M.D.” Practice Location

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