Healthcare Provider Details

I. General information

NPI: 1184721284
Provider Name (Legal Business Name): PETER JAHANGIR PARKER M D INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W GLENOAKS BLVD
GLENDALE CA
91202-2606
US

IV. Provider business mailing address

414 N CAMDEN DR STE 975
BEVERLY HILLS CA
90210-4541
US

V. Phone/Fax

Practice location:
  • Phone: 818-546-2626
  • Fax: 818-546-1056
Mailing address:
  • Phone: 310-276-4715
  • Fax: 310-276-4634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA44924
License Number StateCA

VIII. Authorized Official

Name: DR. PETER J. PARKER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-276-4715