Active NPI
Laelle Louise Peterson
- Pediatrics Physician
- Los Angeles, CA
National Provider Identifier
1619679552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A206752
- Practice address
- 200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-8344 - Phone
- (310) 825-0867
- Fax
- (310) 794-5066
- NPI assigned
- Mar 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A206752 | CA | Primary |
Addresses
Primary practice location
200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-8344
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Other practice location 1
757 Westwood Plz Rm 3108
Los Angeles, CA 90095-1752
Phone (310) 267-9124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260602003161 | CA | Practitioner - Pediatric Medicine | 9335619972 |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A206752 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1619679552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UCLA MEDICAL PLZ STE 265",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958344",
"telephone_number": "310-825-0867",
"fax_number": "310-794-5066"
}
],
"practiceLocations": [
{
"address_1": "757 Westwood Plz Rm 3108",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900951752",
"country_code": "US",
"telephone_number": "310-267-9124",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "LAELLE",
"middle_name": "LOUISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-21",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A206752",
"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 Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.