Provider Demographics
NPI:1043265580
Name:CZULEGER, PETER C (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:C
Last Name:CZULEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26800 CROWN VALLEY PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6365
Mailing Address - Country:US
Mailing Address - Phone:949-276-2111
Mailing Address - Fax:949-276-2115
Practice Address - Street 1:26800 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6365
Practice Address - Country:US
Practice Address - Phone:949-276-2111
Practice Address - Fax:949-276-2115
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA34446207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050618CA27480OtherBEAR VALLEY TRAILBLAZER
CA00A344460OtherBLUE SHIELD
CA00A344460OtherCALOPTIMA
CAA34446OtherBLUE CROSS
CA00A344460Medicaid
CA00A344460OtherCALOPTIMA
CA00A344460OtherBLUE SHIELD