Healthcare Provider Details

I. General information

NPI: 1164780409
Provider Name (Legal Business Name): CHERYL ANDREA COHLER PERETZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH ST FL 4
SAN FRANCISCO CA
94158-2604
US

IV. Provider business mailing address

747 52ND ST DEPARTMENT OF HEMATOLOGY/ONCOLOGY
OAKLAND CA
94609-1809
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-7062
  • Fax:
Mailing address:
  • Phone: 203-434-6923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number131089
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberA131089
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: