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NPI Code Detail

MEDICARE: PETER C PELIKAN M.D.

MEDICARE: PETER C PELIKAN 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
1207RC0000XCardiovascular Disease PhysicianG43904CA
2207RI0011XInterventional Cardiology PhysicianG43904CA

General Provider Information

NPI Number : 1710984331
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER C PELIKAN M.D.
Provider Business Mailing Address
First Line : 2001 SANTA MONICA BLVD
Second Line : SUITE 280W
City : SANTA MONICA
State : CA
Zip : 90404-2102
Country : US
Telephone Number : 310-829-7678
Fax Number : 310-829-6889
Provider Business Practice Location Address
First Line : 2001 SANTA MONICA BLVD STE 280W
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2172
Country : US
Telephone Number : 310-829-7678
Fax Number : 310-829-6889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2005
Last Update Date : 07/26/2021

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Practice Fax: 310-829-6889

Directions to “ PETER C PELIKAN M.D.” Practice Location

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