Active NPI
Leon R. Peck, a Professional Corporationm
- Oral and Maxillofacial Surgery Clinic/Center
- Beverly Hills, CA
National Provider Identifier
1497980874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery Clinic/Center
- Legal business name
- LEON R. PECK, A PROFESSIONAL CORPORATIONM
- Practice address
- 8500 Wilshire Blvd
Suite815
Beverly Hills, CA 90211-3121 - Phone
- (310) 657-6363
- Fax
- (310) 652-5785
- NPI assigned
- May 28, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Leon Robert Peck, DDS, PHD
- Title
- Owner
- Phone
- (310) 657-6363
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery Clinic/Center | 261QS0112X | Primary |
Addresses
Primary practice location
8500 Wilshire Blvd
Suite815
Beverly Hills, CA 90211-3121
Mailing address
8500 Wilshire Blvd
Suite815
Beverly Hills, CA 90211-3121
Phone (310) 657-6363
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Oral and Maxillofacial Surgery (Dentist)
- Beverly Hills, CA
- NPI 1366902462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243468800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1244592000000",
"number": "1497980874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8500 WILSHIRE BLVD",
"address_2": "SUITE815",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902113121",
"telephone_number": "310-657-6363",
"fax_number": "310-652-5785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 WILSHIRE BLVD",
"address_2": "SUITE815",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902113121",
"telephone_number": "310-657-6363",
"fax_number": "310-652-5785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEON R. PECK, A PROFESSIONAL CORPORATIONM",
"organizational_subpart": "NO",
"enumeration_date": "2009-05-28",
"last_updated": "2009-06-10",
"status": "A",
"authorized_official_last_name": "PECK",
"authorized_official_first_name": "LEON",
"authorized_official_middle_name": "ROBERT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "310-657-6363",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS, PHD"
},
"taxonomies": [
{
"code": "261QS0112X",
"taxonomy_group": "",
"desc": "Clinic/Center, Oral and Maxillofacial Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.