Pete Petriashvili

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

11301 Wilshire Blvd, Building 500, Room 4455
Los Angeles, CA 90073

Phone

(310) 562-2015

NPI assigned

Jan 27, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1306177654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD, BUILDING 500, ROOM 4455",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90073",
            "telephone_number": "310-562-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD, BUILDING 500, ROOM 4455",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90073",
            "telephone_number": "310-562-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIASHVILI",
        "first_name": "PETE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Petko, MD, MPH
• Andrew John Petkus, PH.D.
• Alexandra Petrasek, MS, CGC
• Dominique Petrassi
• Anastasia Petrenco, NP
• Ashley Petrie
• David Petrie, MA
• Morgan Petriello
• Pamela Petrigliano
• Andrey Petrikovets, M.D.

• Student in an Organized Health Care Education/Training Program in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.