Provider Demographics
NPI:1730324674
Name:PEAKE, JOHN LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEWIS
Last Name:PEAKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 RODMAN DR
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-4325
Mailing Address - Country:US
Mailing Address - Phone:805-534-0152
Mailing Address - Fax:
Practice Address - Street 1:2728 RODMAN DR
Practice Address - Street 2:
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-4325
Practice Address - Country:US
Practice Address - Phone:805-534-0152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG837922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry