Provider Demographics
NPI:1619167087
Name:PEKEROL, MEHMET CENAB (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHMET
Middle Name:CENAB
Last Name:PEKEROL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:STE 616
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3701
Mailing Address - Country:US
Mailing Address - Phone:310-858-0880
Mailing Address - Fax:310-858-0885
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:STE 616
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-858-0880
Practice Address - Fax:310-858-0885
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA51117207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A511170Medicaid
CA00A511170Medicaid
CAA51117Medicare PIN