Wallace W Peck is a Neuroradiology in Pasadena, California. Wallace W Peck practices all healthcare services and medical treatments related to Neuroradiology. The NPI Number for Wallace W Peck is 1508810367. The last update date is 2007-12-19.
Wallace W Peck's current location address is Dept La 21555, Pasadena, California. You can contact this provider via phone number 9497645570 and fax number 9492631639. The mailing address for Wallace W Peck is Dept La 21555, Pasadena, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wallace W Peck |
|---|---|
| Address | Dept La 21555, Pasadena, California |
| Phone Number | 9497645570 |
| Fax Number | 9492631639 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1508810367 |
|---|---|
| Provider Enumeration Date | 2006-05-19 |
| Last Updated Date | 2007-12-19 |
Provider Mailing Address Detail
| Address | Dept La 21555 |
|---|---|
| City | Pasadena |
| State | California (CA) |
| Post Code | 911851555 |
| Phone Number | 9497645570 |
| Fax Number | 9492631639 |
Provider's Primary Taxonomy Detail
| Speciality | Neuroradiology |
|---|---|
| Taxonomy | 2085N0700X |
| Licence No | G52810 |
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Definition: A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00G528100 | CA | BLUE SHIELD | |
| 00G528100 | CA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Wallace W Peck by the Centers for Medicare & Medicaid Services?
The Wallace W Peck has been issued the NPI (National Provider Identifier) 1508810367, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Wallace W Peck?
The Wallace W Peck is situated at Dept La 21555, in the city of Pasadena, state of CA, with the zip code 911851555.
What is the area of specialization for Wallace W Peck, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Wallace W Peck is Neuroradiology, and the corresponding taxonomy code that categorizes this area of expertise is 2085N0700X.
On what date did the Wallace W Peck receive the assignment of its 1508810367 from the Centers for Medicare & Medicaid Services?
The Wallace W Peck was issued its 1508810367 by the Centers for Medicare & Medicaid Services on 2006-05-19.
As of what date were the Wallace W Peck's details last updated?
The information pertaining to the Wallace W Peck, including its address, specialty, and other details, was most recently updated on 2007-12-19.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY