Gary Neil Pesselnick, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

G24943 Issued in CA

Practice address

1512 Arroyo View St
Thousand Oaks, CA 91320-6581

Phone

(818) 383-2005

NPI assigned

Jul 12, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1518992171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 ARROYO VIEW ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206581",
            "telephone_number": "818-383-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 ARROYO VIEW ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206581",
            "telephone_number": "818-383-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSELNICK",
        "first_name": "GARY",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G24943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G24943",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "WG 24943A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Edward Pero, M.D.
• Brent Perry, BCABA
• Ian C Perry
• Sara Perry, BCBA
• Karen Solomon Persichetti, M.A., O.T.R.
• Nathaniel Christopher Peters
• Alexis Peterson
• Karen Lynne Peterson, M.A.
• Archana Yogesh Petkar, M.D
• Artin Petokian

• Anatomic Pathology & Clinical Pathology Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.