Provider Demographics
NPI:1326066671
Name:PEAK, SCOTT JASON (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JASON
Last Name:PEAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1150 VETERANS BLVD
Mailing Address - Street 2:KAISER PERMANENTE DEPARTMENT OF NEUROSURGERY 3RD FLOOR
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2037
Mailing Address - Country:US
Mailing Address - Phone:650-299-2290
Mailing Address - Fax:650-299-2677
Practice Address - Street 1:1150 VETERANS BLVD
Practice Address - Street 2:KAISER PERMANENTE DEPARTMENT OF NEUROSURGERY 3RD FLOOR
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2037
Practice Address - Country:US
Practice Address - Phone:650-299-2290
Practice Address - Fax:650-299-2677
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-01-04
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Provider Licenses
StateLicense IDTaxonomies
CAA79065207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA79065AMedicare ID - Type UnspecifiedPPIN #
CAI06293Medicare UPIN