Provider Demographics
NPI:1760693733
Name:PETER B WEBER MD INC
Entity Type:Organization
Organization Name:PETER B WEBER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:415-885-8628
Mailing Address - Street 1:2100 WEBSTER ST
Mailing Address - Street 2:115
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2373
Mailing Address - Country:US
Mailing Address - Phone:415-885-8628
Mailing Address - Fax:415-923-3325
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:115
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2373
Practice Address - Country:US
Practice Address - Phone:415-885-8628
Practice Address - Fax:415-923-3325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53445207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A534450OtherBC BS NUMBER
ZZZ21532ZMedicare PIN
CAF64854Medicare UPIN