Provider Demographics
NPI:1487186318
Name:PEYTON, MICHAEL LINO FELIPE (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL LINO
Middle Name:FELIPE
Last Name:PEYTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:505 S MAIN ST STE 525
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4553
Mailing Address - Country:US
Mailing Address - Phone:714-456-5631
Mailing Address - Fax:714-285-0389
Practice Address - Street 1:18411 CLARK ST STE 302
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3541
Practice Address - Country:US
Practice Address - Phone:818-501-7276
Practice Address - Fax:818-501-7288
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1590092080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine