Active NPI
Peter Tontonoz, MD
- Anatomic Pathology Physician
- Los Angeles, CA
National Provider Identifier
1003845785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- A65732
- Practice address
- 10833 Le Conte Ave
Ste B-186 CHS
Los Angeles, CA 90095-3075 - Phone
- (310) 794-8285
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | A65732 | CA | Primary |
Addresses
Primary practice location
10833 Le Conte Ave
Ste B-186 CHS
Los Angeles, CA 90095-3075
Mailing address
5767 W. Century Blvd
#400
Los Angeles, CA 90045-5655
Phone (310) 794-7953
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A657320 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A65732 | CA | MD | Anatomic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299456000000",
"number": "1003845785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W. CENTURY BLVD",
"address_2": "#400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455655",
"telephone_number": "310-794-7953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE",
"address_2": "STE B-186 CHS",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900953075",
"telephone_number": "310-794-8285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONTONOZ",
"first_name": "PETER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2011-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "CA",
"license": "A65732",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A657320",
"state": "CA"
}
],
"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 Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.