Provider Demographics
NPI:1659407534
Name:KAPPEL, PETER JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOHN
Last Name:KAPPEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1908 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1927
Mailing Address - Country:US
Mailing Address - Phone:310-829-5475
Mailing Address - Fax:310-828-1359
Practice Address - Street 1:1908 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1927
Practice Address - Country:US
Practice Address - Phone:310-829-5475
Practice Address - Fax:310-828-1359
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2021-12-20
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Provider Licenses
StateLicense IDTaxonomies
CAA88426207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA88426BMedicare PIN