Provider Demographics
NPI:1831597756
Name:PECHSTEDT, DANIEL (FNP)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:PECHSTEDT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 SKYPARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5034
Mailing Address - Country:US
Mailing Address - Phone:310-784-6300
Mailing Address - Fax:
Practice Address - Street 1:3333 SKYPARK DR STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5034
Practice Address - Country:US
Practice Address - Phone:310-784-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA837113163WX0200X
CANP95001983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology