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NPI Code Detail

MEDICARE: PETER W WELTY M.D.

MEDICARE: PETER W WELTY 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
1174400000XSpecialistA43081CA

General Provider Information

NPI Number : 1356497226
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER W WELTY M.D.
Provider Business Mailing Address
First Line : 2921 REDONDO AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-2415
Country : US
Telephone Number : 562-426-5551
Fax Number : 562-426-9977
Provider Business Practice Location Address
First Line : 2921 REDONDO AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-2415
Country : US
Telephone Number : 562-426-5551
Fax Number : 562-426-9977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 07/08/2007

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