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NPI Code Detail

MEDICARE: DR. CHRISTINA LOUISE PERETZ M.D.

MEDICARE: DR. CHRISTINA LOUISE PERETZ M.D.
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
1207Q00000XFamily Medicine PhysicianA110938CA

General Provider Information

NPI Number : 1487852497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINA LOUISE PERETZ M.D.
Provider Business Mailing Address
First Line : 530 CENTRAL AVE
Second Line :
City : MENLO PARK
State : CA
Zip : 94025-2807
Country : US
Telephone Number : 510-289-2366
Fax Number :
Provider Business Practice Location Address
First Line : 1286 SANCHEZ ST STE A
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94114-3833
Country : US
Telephone Number : 415-642-0333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2007
Last Update Date : 10/05/2011

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