Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5312T | CA |
NPI | 1033240254 |
---|---|
Provider Name | Dr. Peter Robert Nehrebecki |
First Address | San Francisco, CA 94110-1323 |
Second Address | San Francisco, CA 94110-1323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 15/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SD0053120 | (05) | CA |