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NPI Code Detail

MEDICARE: LUON W PENG DO

MEDICARE:   LUON W PENG  DO
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
1207RN0300XNephrology Physician20A8244CA

General Provider Information

NPI Number : 1407937105
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUON W PENG DO
Provider Business Mailing Address
First Line : 3731 E 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90063-2401
Country : US
Telephone Number : 323-222-4848
Fax Number : 323-222-4800
Provider Business Practice Location Address
First Line : 3731 E 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90063-2401
Country : US
Telephone Number : 323-222-4848
Fax Number : 323-222-4800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 11/02/2016

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Directions to “ LUON W PENG DO” Practice Location

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