Provider Demographics
NPI:1538293360
Name:PENINSULA PROCEDURE CENTER, LP
Entity Type:Organization
Organization Name:PENINSULA PROCEDURE CENTER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-995-1259
Mailing Address - Street 1:121 GRAY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1800
Mailing Address - Country:US
Mailing Address - Phone:888-282-7472
Mailing Address - Fax:
Practice Address - Street 1:369 MAIN STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063
Practice Address - Country:US
Practice Address - Phone:650-366-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical