Provider Demographics
NPI:1922797380
Name:PEKUR, ANNA ESABELLE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:ESABELLE
Last Name:PEKUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANYA
Other - Middle Name:ESABELLE
Other - Last Name:PEKUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1433 S ROBERTSON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3414
Mailing Address - Country:US
Mailing Address - Phone:310-785-2121
Mailing Address - Fax:
Practice Address - Street 1:1433 S ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-3414
Practice Address - Country:US
Practice Address - Phone:310-785-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker