Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A105023 | CA |
NPI | 1033388269 |
---|---|
Provider Name | Ms. Melicent Clare Peck |
First Address | San Francisco, CA 94143-0654 |
Second Address | San Francisco, CA 94143-0654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2008 |
Last Update Date | 14/05/2013 |