Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G57811 | CA |
Y | 208600000X | Surgeon | G57811 | CA |
NPI | 1023079902 |
---|---|
Provider Name | Dr. Peter C. Meade |
First Address | French Camp, CA 95231-9693 |
Second Address | French Camp, CA 95231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 13/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F38089 | (02) | CA |