Provider Demographics
NPI:1487852497
Name:PERETZ, CHRISTINA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:PERETZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2807
Mailing Address - Country:US
Mailing Address - Phone:510-289-2366
Mailing Address - Fax:
Practice Address - Street 1:1286 SANCHEZ ST STE A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3833
Practice Address - Country:US
Practice Address - Phone:415-642-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110938207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine