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General NPI Number Information
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NPI Number | 1033071121
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Entity Type | Organization
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Legal Business Name | PEAK HEALTH MEDICAL GROUP, P.A.
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 3388 17TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-7201
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Country | US
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Telephone | 408-203-7959
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Fax |
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Provider Business Mailing Address
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Address Line | 810 BEAR GULCH RD
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City | WOODSIDE
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State | CA
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Zip | 94062-4430
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Country | US
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Telephone | 408-203-7959
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL EDNIE
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Credential | MD, RD
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Telephone | 408-203-7959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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