Peak Health Medical Group Inc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

A61896 Issued in CA

Legal business name

PEAK HEALTH MEDICAL GROUP INC

Doing business as

Peak Health Medical Group

Practice address

2143 S Sepulveda Blvd
Suite 300
Los Angeles, CA 90025-5733

Phone

(310) 575-3100

NPI assigned

May 8, 2013

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Other names 1

• Peak Health Medical Group Doing business as

Tax ID family

Peak Health Medical Group2 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peak Health Medical Group Inc

  • Nurse Practitioner
  • Santa Monica, CA
  • NPI 1386072429
  NPD tax ID

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1689019382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 S SEPULVEDA BLVD",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255733",
            "telephone_number": "310-575-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A61896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peaceful Cure Hospice Care
• Peaceful Mind Centers, LLC
• Peaceful Stay LLC
• Warwick John Peacock, M.D.
• Peak Health Medical Group Inc
• Peak Performance Transport
• Peak Psychology Inc
• Kimberly Peak, PSY.D.
• Daniel Pearce, MD
• Julie L. Pearce, PSY.D.

• Non-Pharmacy Dispensing Site in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.