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General NPI Number Information
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NPI Number | 1376569475
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Entity Type | Individual
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Provider Name | MARCIA C PECK MD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 20130 LAKE CHABOT RD SUITE 201
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5340
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Country | US
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Telephone | 510-204-2574
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Fax | 510-886-8466
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Provider Business Mailing Address
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Address Line | 20130 LAKE CHABOT RD SUITE 201
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5340
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Country | US
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Telephone | 510-204-2574
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Fax | 510-886-8466
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | A75655
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License Number State | CA
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