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General NPI Number Information
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NPI Number | 1538337126
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Entity Type | Individual
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Provider Name | JEREMY WILLIAM PEAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 03/04/2010
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Provider Practice Location Address
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Address Line | 200 W ARBOR DR DEPT 8819
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City | SAN DIEGO
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State | CA
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Zip | 92103-8819
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Country | US
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Telephone | 619-543-6213
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Fax |
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Provider Business Mailing Address
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Address Line | P.0. 90263
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City | SAN DIEGO
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State | CA
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Zip | 92169
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Country | US
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Telephone | 619-203-8628
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A97935
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License Number State | CA
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