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General NPI Number Information
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NPI Number | 1457146482
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Entity Type | Organization
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Legal Business Name | PELANGI INC
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 6677 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90038-1374
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Country | US
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Telephone | 302-333-4778
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Fax |
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Provider Business Mailing Address
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Address Line | 6677 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90038-1374
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Country | US
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Telephone | 302-333-4778
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Fax |
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Authorized Official
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Title or Position | BUSINESS DIRECTOR
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Name | MR. MICHAEL AARON LEDDY
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Credential |
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Telephone | 405-757-8197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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