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General NPI Number Information
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NPI Number | 1447227392
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Entity Type | Individual
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Provider Name | PETER B. SLABAUGH MD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 3315 BROADWAY
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City | OAKLAND
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State | CA
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Zip | 94611-5717
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Country | US
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Telephone | 510-849-2300
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Fax | 510-849-2333
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Provider Business Mailing Address
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Address Line | 200 PORTER DR SUITE 215
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City | SAN RAMON
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State | CA
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Zip | 94583-1587
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Country | US
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Telephone | 925-362-2166
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Fax | 855-574-3055
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | G23442
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License Number State | CA
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