Provider Demographics
NPI:1518992262
Name:SZOLCSANYI, PETER (PA)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:SZOLCSANYI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78822 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2046
Mailing Address - Country:US
Mailing Address - Phone:760-777-7701
Mailing Address - Fax:
Practice Address - Street 1:78822 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2046
Practice Address - Country:US
Practice Address - Phone:760-777-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16647363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPA166470Medicare PIN
CAP83769Medicare UPIN
CAOPA166471Medicare PIN