Provider Demographics
NPI:1821346636
Name:SANTA MARIA, PETER LUKE (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:LUKE
Last Name:SANTA MARIA
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 WELCH RD
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94035
Mailing Address - Country:US
Mailing Address - Phone:650-815-6781
Mailing Address - Fax:
Practice Address - Street 1:801 WELCH RD
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94035
Practice Address - Country:US
Practice Address - Phone:650-815-6781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF5720207YX0901X
CA491207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology