Healthcare Provider Details

I. General information

NPI: 1609975309
Provider Name (Legal Business Name): PETER L FORSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 GOUGH ST SUITE 211
SAN FRANCISCO CA
94102-5946
US

IV. Provider business mailing address

548 MARKET ST 18351
SAN FRANCISCO CA
94104-5401
US

V. Phone/Fax

Practice location:
  • Phone: 415-551-0520
  • Fax: 415-551-0524
Mailing address:
  • Phone: 415-551-0520
  • Fax: 415-551-0524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG058999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: