Provider Demographics
NPI:1639551955
Name:PELOIAN, JOHN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:PELOIAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 300-4
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1085
Mailing Address - Country:US
Mailing Address - Phone:424-209-8711
Mailing Address - Fax:
Practice Address - Street 1:12401 WILSHIRE BLVD
Practice Address - Street 2:SUITE 300-4
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1085
Practice Address - Country:US
Practice Address - Phone:424-209-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27345103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical