Organization Active NPI

Sherri Peace, MD, Inc

  • Medical Specialty Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1407043680
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
G72196 Issued in CA
Legal business name
SHERRI PEACE, MD, INC
Practice address
8930 S Sepulveda Blvd
Suite 104
Los Angeles, CA 90045-3606
Phone
(310) 645-6001
Fax
(310) 645-5919
NPI assigned
Oct 1, 2007
Last updated
Feb 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Authorized official

Name
Dr. Sherri Peace, MDNPI 1962549279
Title
President/Medical Director
Phone
(310) 645-6001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G72196 CA Primary

Addresses

Primary practice location

8930 S Sepulveda Blvd
Suite 104
Los Angeles, CA 90045-3606

Mailing address

8930 S Sepulveda Blvd
Suite 104
Los Angeles, CA 90045-3606
Phone (310) 645-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041022001159 CA Part B Supplier - Clinic/Group Practice 6507827441 Receives reassigned benefits from 2 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1407043680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 S SEPULVEDA BLVD",
            "address_2": "SUITE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453606",
            "telephone_number": "310-645-6001",
            "fax_number": "310-645-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 S SEPULVEDA BLVD",
            "address_2": "SUITE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453606",
            "telephone_number": "310-645-6001",
            "fax_number": "310-645-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERRI PEACE, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "PEACE",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-645-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G72196",
            "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 Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.