Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD419009 | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | C155411 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | MD419009 | PA |
NPI | 1003829771 |
---|---|
Provider Name | Dr. Peter Andrew Meaney |
First Address | Palo Alto, CA 94304-1601 |
Second Address | Palo Alto, CA 94304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 20/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
090573EMD | MEDICARE PTAN (01) | PA |
1012936160 | (05) | PA |
I28722 | (02) | PA |