MEDICARE: PETER F. AFSARI D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	20A12976	CA
2	2084P0800X	Psychiatry Physician	20A12976	CA

General Provider Information

NPI Number	:	1013126143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER F. AFSARI D.O.

Provider Business Mailing Address
First Line	:	3835 N FREEWAY BLVD
Second Line	:	STE 100
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1928
Country	:	US
Telephone Number	:	916-576-7898
Fax Number	:	916-285-0338

Provider Business Practice Location Address
First Line	:	1039 MURRAY AVE STE 220
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93405-2058
Country	:	US
Telephone Number	:	805-250-2996
Fax Number	:	805-250-2998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	03/23/2018

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