MEDICARE: PEGGY VETTER LM, CLD, LCCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	LM750	CA

General Provider Information

NPI Number	:	1205644218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY VETTER LM, CLD, LCCE

Provider Business Mailing Address
First Line	:	2131 S EL CAMINO REAL STE 101102
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6204
Country	:	US
Telephone Number	:	760-500-1316
Fax Number	:

Provider Business Practice Location Address
First Line	:	2131 S EL CAMINO REAL STE 101102
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6204
Country	:	US
Telephone Number	:	760-500-1316
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	08/14/2025

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