Provider Demographics
NPI:1134255052
Name:KLATSKY, PETER (MD, MPH)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:KLATSKY
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DANIEL BURNHAM CT STE 110C
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-0456
Mailing Address - Country:US
Mailing Address - Phone:415-964-5618
Mailing Address - Fax:415-964-5619
Practice Address - Street 1:1 DANIEL BURNHAM CT
Practice Address - Street 2:SUITE 110C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5455
Practice Address - Country:US
Practice Address - Phone:415-964-5618
Practice Address - Fax:415-964-5619
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91127207V00000X, 207VE0102X
NY245878207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology