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General NPI Number Information
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NPI Number | 1790836500
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Entity Type | Individual
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Provider Name | ANTHONY CARL PICKETT M.D., F.A.C.O.G.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 5859 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90044-3741
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Country | US
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Telephone | 323-753-2229
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Fax |
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Provider Business Mailing Address
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Address Line | 4230 S FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90037-2640
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Country | US
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Telephone | 323-846-7200
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Fax | 323-846-7206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G076921
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License Number State | CA
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