Provider Demographics
NPI:1922024777
Name:SCHEID, PETER JOHN ELLIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOHN ELLIOT
Last Name:SCHEID
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:34249 CAMINO CAPISTRANO
Mailing Address - Street 2:
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1138
Mailing Address - Country:US
Mailing Address - Phone:949-359-5663
Mailing Address - Fax:949-542-3878
Practice Address - Street 1:34249 CAMINO CAPISTRANO
Practice Address - Street 2:
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624-1138
Practice Address - Country:US
Practice Address - Phone:949-629-4140
Practice Address - Fax:949-229-7684
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA070698207Q00000X
CAA70698207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA244542Medicaid
CA244542Medicaid