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NPI Code Detail

MEDICARE: DR. PETER GARVEY MAYER D.D.S.

MEDICARE: DR. PETER GARVEY MAYER D.D.S.
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
11223E0200XEndodontics47948CA

General Provider Information

NPI Number : 1225229339
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER GARVEY MAYER D.D.S.
Provider Business Mailing Address
First Line : 2655 CAMINO DEL RIO N STE 150
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1603
Country : US
Telephone Number : 619-282-7088
Fax Number : 619-297-0504
Provider Business Practice Location Address
First Line : 2655 CAMINO DEL RIO N STE 150
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1603
Country : US
Telephone Number : 619-282-7088
Fax Number : 619-297-0504
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2007
Last Update Date : 08/05/2007

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