Healthcare Provider Details

I. General information

NPI: 1598292302
Provider Name (Legal Business Name): MEGAN PELTER M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST
LOMA LINDA CA
92350-1716
US

IV. Provider business mailing address

2068 ORANGE TREE LN STE 215
REDLANDS CA
92374-4555
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4756
  • Fax:
Mailing address:
  • Phone: 909-558-4756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA161455
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA16145
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA161455
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberA161455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: