Healthcare Provider Details

I. General information

NPI: 1558366872
Provider Name (Legal Business Name): RICHARD LEIGHTON PEATMAN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16893 PLACER HILLS RD
MEADOW VISTA CA
95722-9531
US

IV. Provider business mailing address

875 SPRUCE DR
MEADOW VISTA CA
95722-9503
US

V. Phone/Fax

Practice location:
  • Phone: 530-878-7440
  • Fax: 530-878-2470
Mailing address:
  • Phone: 530-878-8864
  • Fax: 530-878-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number32014
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA10712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: