Provider Demographics
NPI:1780020065
Name:PETER A LINFOOT PHD MD INC.
Entity Type:Organization
Organization Name:PETER A LINFOOT PHD MD INC.
Other - Org Name:DIABETES AND ENDOCRINE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:LINFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:925-962-1240
Mailing Address - Street 1:978 2ND ST
Mailing Address - Street 2:STE 220
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4538
Mailing Address - Country:US
Mailing Address - Phone:925-926-1240
Mailing Address - Fax:925-962-6984
Practice Address - Street 1:978 2ND ST
Practice Address - Street 2:STE 220
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4538
Practice Address - Country:US
Practice Address - Phone:925-926-1240
Practice Address - Fax:925-962-6984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG071944207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF76693Medicare UPIN