Provider Demographics
NPI:1023030582
Name:WEBB, PETER (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:525 SOUTH DR STE 115
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4211
Mailing Address - Country:US
Mailing Address - Phone:650-969-5600
Mailing Address - Fax:650-969-0360
Practice Address - Street 1:136 N SAN MATEO DR FL 2
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2778
Practice Address - Country:US
Practice Address - Phone:650-348-1242
Practice Address - Fax:650-348-0788
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG35018207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA942881809OtherPROVIDER ID
CA00G350180Medicare ID - Type Unspecified