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NPI Code Detail

MEDICARE: DR. ROBERT DOUGLAS PEETE DOCTOR OF PHARMACY

MEDICARE:  DR. ROBERT DOUGLAS PEETE  DOCTOR OF PHARMACY
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
1183500000XPharmacist32926CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PHA476060OTHERCABOARD OF PHARMACY LICENSE

General Provider Information

NPI Number : 1891080461
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT DOUGLAS PEETE DOCTOR OF PHARMACY
Provider Business Mailing Address
First Line : 2169 W REDONDO BEACH BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90247-3625
Country : US
Telephone Number : 310-515-3783
Fax Number : 310-515-3783
Provider Business Practice Location Address
First Line : 2169 W REDONDO BEACH BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90247-3625
Country : US
Telephone Number : 310-515-3783
Fax Number : 310-515-3783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2011
Last Update Date : 06/12/2011

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Directions to “ DR. ROBERT DOUGLAS PEETE DOCTOR OF PHARMACY” Practice Location

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