Healthcare Provider Details

I. General information

NPI: 1679715932
Provider Name (Legal Business Name): PETER FARMER DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 12/29/2024
Certification Date: 12/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2191 MARKET ST STE B
SAN FRANCISCO CA
94114-4305
US

IV. Provider business mailing address

2191 MARKET ST STE B
SAN FRANCISCO CA
94114-4305
US

V. Phone/Fax

Practice location:
  • Phone: 415-255-0400
  • Fax: 415-255-0420
Mailing address:
  • Phone: 415-255-0400
  • Fax: 415-255-0420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number45570
License Number StateCA

VIII. Authorized Official

Name: DR. PETER FARMER
Title or Position: OWNER/PRESIDENT
Credential: DDS
Phone: 415-637-3868