Active NPI
Gary Pedneault, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1003076845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A48685
- Practice address
- 7257 W Manchester Ave Apt 3
Los Angeles, CA 90045-3517 - Phone
- (310) 410-8266
- NPI assigned
- Jun 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A48685 | CA | Primary |
Addresses
Primary practice location
7257 W Manchester Ave Apt 3
Los Angeles, CA 90045-3517
Mailing address
PO Box 2952
Beverly Hills, CA 90213-2952
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 6, 2025 through May 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A48685 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1003076845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2952",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902132952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7257 W MANCHESTER AVE APT 3",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900453517",
"telephone_number": "310-410-8266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDNEAULT",
"first_name": "GARY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-16",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A48685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.