Provider Demographics
NPI:1447245220
Name:CALDWELL, PETER CRAIG (PD)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:CRAIG
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2513
Mailing Address - Country:US
Mailing Address - Phone:805-965-4528
Mailing Address - Fax:805-966-1844
Practice Address - Street 1:1509 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2513
Practice Address - Country:US
Practice Address - Phone:805-965-4528
Practice Address - Fax:805-966-1844
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist