Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC25349 | CA |
NPI | 1104917566 |
---|---|
Provider Name | Dr. Peter Mcduff |
First Address | Walnut Creek, CA 94598-2666 |
Second Address | Walnut Creek, CA 94598-2666 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 16/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GE004A | PTAN (01) | CA |
U75000 | (02) | CA |