PETER D. SLISKOVICH, MD, INC. (NPI# 1316248313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316248313 |
| Entity Type | Organization |
| Organization Name | PETER D. SLISKOVICH, MD, INC. |
| Practice Address |
1360 W 6th St Suite 120 West Building San Pedro CA 90732-3514 |
| Practice Telephone | 3108332461 |
| Practice Fax Number | 3108336342 |
| Mailing Telephone | 3108332461 |
| Mailing Fax Number | 3108336342 |
| Enumeration Date | 2010-11-06 |
| Last Update Date | 2010-11-06 |
| Authorized Official Name | DR. PETER DAN SLISKOVICH (OWNER/PRESIDENT) |
| Authorized Official Telephone | 3108332461 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G42414 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | G42414 | 01 |
| CA | 00G424140 | 05 |
| Street Address |
1360 W 6TH ST SUITE 120 WEST BUILDING |
| City | SAN PEDRO |
| State | CA |
| Zip Code | 90732-3514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821092859 | Carmen C Capodanno | Dermatology | 1360 W 6th St, Ste 270, San Pedro, CA 90732-3539 | 2005-06-08 |
| 1760832851 | Harbor Foot and Ankle Podiatric Medical Group | Podiatrist | 1360 W 6th St, Suite 150w, San Pedro, CA 90732-3514 | 2016-06-20 |
| 1861850141 | Rebecca Li | Physical Therapy Assistant | 1360 W 6th St, Suite 210, San Pedro, CA 90732-3514 | 2016-02-02 |
| 1891176616 | Bruce D. Levine, D.p.m., Professional Corporation | Non-Pharmacy Dispensing Site | 1360 W 6th St, Suite 150, West Building, San Pedro, CA 90732-3514 | 2015-06-17 |
| 1750799771 | Matin R Hemmat | Internal Medicine | 1360 W 6th St, Suite 120 West Building, San Pedro, CA 90732-3514 | 2014-07-23 |
| 1457790339 | San Pedro Surgery Center, Inc. | Clinic/Center | 1360 W 6th St, Suite D, San Pedro, CA 90732-3514 | 2013-06-24 |
| 1740539048 | Lori Rochelle Krieger | Pediatrics | 1360 W 6th St, Suite 300, San Pedro, CA 90732-3514 | 2012-08-31 |
| 1083997985 | Barry Rodgveller Dpm Podiatry Corporation | Podiatrist | 1360 W 6th St, Suite 240, San Pedro, CA 90732-3514 | 2011-09-27 |
| 1205135878 | James T London M D A Professional Corporation | Orthopaedic Surgery | 1360 W 6th St, Suite 305, San Pedro, CA 90732-3569 | 2011-03-22 |
| 1255649612 | Eyecare Specialists Medical Group, Inc. | Ophthalmology | 1360 W 6th St, North Bldg Suite 125, San Pedro, CA 90732-3514 | 2010-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771241 | Alicia Avila | Student in an Organized Health Care Education/Training Program | 2227 Blue Butterfly Way, #7, San Pedro, CA 90732 | 2020-08-24 |
| 1619500543 | Udana Harris | Registered Nurse | 1300 West 7th Street, Obhc Unit, San Pedro, CA 90732 | 2020-02-19 |
| 1861042301 | Patricia Elaine Moses | Technician | 106 N. Western Ave Unit 102, San Pedro, CA 90732 | 2019-09-17 |
| 1629627393 | Antonio Ramon Martinez | Technician | 3141 Blue Butterfly Unit 66, San Pedro, CA 90732 | 2019-09-05 |
| 1487207700 | Victoria A. Shook, D.d.s., A Professional Corp. | Dentist | 28138 S. Western Ave., San Pedro, CA 90732 | 2019-07-17 |
| 1144566563 | Shaun E Chandran M D Inc | Orthopaedic Surgery | 1360 W 6th Street, Suite 305, San Pedro, CA 90732 | 2012-12-13 |
| 1316281280 | Jenny Luong | Physician Assistant | 1534 W. 25th St, San Pedro, CA 90732 | 2012-11-16 |
| 1033429519 | Eric M Feit Dpm Inc | Podiatrist | 1360 West 6th St., Suite 240, San Pedro, CA 90732 | 2010-10-18 |
| 1386808673 | Meysam Zaker | Dentist | 2470 S. Western Ave, San Pedro, Ca, CA 90732 | 2008-07-15 |
| 1376735340 | Francisco J. Correa, M.d., Inc | General Practice | 1350 W. 6th St, #3, San Pedro, CA 90732 | 2007-08-14 |
| Find all providers in zip 90732 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841603586 | Ali Ahmad Medical Corp | Family Medicine | 350 W 5th St Ste 105, San Pedro, CA 90731-2751 | 2014-06-10 |
| 1922351303 | Medical Plaza of San Pedro Inc. | Family Medicine | 529 W 7th St, San Pedro, CA 90731-3115 | 2012-10-22 |
| 1700958667 | Phillip Edward Schoenwetter | Family Medicine | 787 W 9th St, San Pedro, CA 90731-3601 | 2006-11-15 |
| 1245321272 | David H Smith | Family Medicine | 1360 W 6th St Ste D, San Pedro, CA 90732-3554 | 2006-09-27 |
| 1598711319 | Angel George Angelow | Family Medicine | 1499 W 1st St, San Pedro, CA 90732-3255 | 2006-05-25 |
| 1629078969 | Allan I Larner | Family Medicine | 921 S Beacon St, San Pedro, CA 90731-3740 | 2005-07-28 |
| 1831660588 | Krupa Shah Md, A Professional Corporation | Family Medicine | 1294 W 6th St Ste 204, San Pedro, CA 90731-2998 | 2018-12-06 |
| 1114474350 | Shanna Lee Darling | Family Medicine | 1350 W 6th St, San Pedro, CA 90732-3544 | 2016-09-06 |
| 1760835086 | Dr. Gregory A. Smith, Md Inc. | Family Medicine | 715 S Averill Ave, San Pedro, CA 90732-3813 | 2016-07-21 |
| 1326396664 | Nathaniel Leong | Family Medicine | 1300 W 7th St, San Pedro, CA 90732-3505 | 2012-08-16 |
| Find all providers in SAN PEDRO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.