Louella Peckson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A53093 Issued in CA

Practice address

14624 Sherman Way
Suite 401
Van Nuys, CA 91405-2241

Phone

(818) 786-1200

Fax

(818) 786-1201

NPI assigned

Oct 10, 2006

Last updated

Jul 21, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Louella Peckson, M.D., Inc.

  • Pediatric Adolescent Medicine Physician
  • Van Nuys, CA
  • NPI 1144516295
  NPD (past) Authorized official
• Racquel S Quema MD Inc

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1881139178
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1467540021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY",
            "address_2": "SUITE 401",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052241",
            "telephone_number": "818-786-1200",
            "fax_number": "818-786-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY",
            "address_2": "SUITE 401",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052241",
            "telephone_number": "818-786-1200",
            "fax_number": "818-786-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKSON",
        "first_name": "LOUELLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A53093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A530930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peaceful Horizon Hospice Care
• Peaceful Hospice Inc.
• Peaceful Living Board & Care, Inc.
• Peaceful Path Hospice Care
• Eldridge H Pearsall, M.D.
• Jake Pederson
• Pediatric Hospital Care Associates, Inc
• Lorna Katherine Peer, PSY.D.
• Maria Celica Pellegrini, D.D.S.
• Ricardo Angel Pellegrini, DDS

• Pediatrics Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.