Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 027913 | CA |
NPI | 1619196235 |
---|---|
Provider Name | Dr. George A. Peeples |
First Address | Arcadia, CA 91006-2218 |
Second Address | El Monte, CA 91780 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |