Jacob B Pelta MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G23606 Issued in CA

Legal business name

JACOB B PELTA MD

Practice address

6360 Wilshire Blvd
Suite # 501
Los Angeles, CA 90048-5603

Phone

(323) 653-6166

Fax

(323) 653-6171

NPI assigned

Oct 27, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacob B Pelta, MDNPI 1477664217

Title

Owner

Phone

(323) 653-6166

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob B Pelta, MD

  • Rheumatology Physician
  • Los Angeles, CA
  • NPI 1477664217
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1245530922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 WILSHIRE BLVD",
            "address_2": "SUITE # 501",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485603",
            "telephone_number": "323-656-3616",
            "fax_number": "323-653-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 WILSHIRE BLVD",
            "address_2": "SUITE # 501",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485603",
            "telephone_number": "323-653-6166",
            "fax_number": "323-653-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB B PELTA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "PELTA",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-653-6166",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G23606",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "G23606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willie Lee Jackson Jr.
• Willye Dorethea Jackson, MSW
• Xochitl L Jackson, MD
• Zianna Jackson
• Agata J Jacniacki, RD
• Jacob J. Orphali
• Jacob Jacque Ahdoot MD a Professional Corporation
• Jacob M. Tsadok M.D. Inc
• Jacob Rajfer M D Inc
• Esther Jacob, LCSW

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.