Healthcare Provider Details

I. General information

NPI: 1053051805
Provider Name (Legal Business Name): MR. DAVID PEPRAH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 OLIVE VIEW DR
SYLMAR CA
91342-1437
US

IV. Provider business mailing address

1445 BUSH ST
SAN FRANCISCO CA
94109-5520
US

V. Phone/Fax

Practice location:
  • Phone: 747-210-3000
  • Fax:
Mailing address:
  • Phone: 415-972-4600
  • Fax: 415-975-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA187888
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: