Disalvo, Peter

Disalvo, Peter is an sole proprietor health care provider with primary practice located at 2320 Midway Dr , Santa Rosa CA 95405-5017. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Disalvo, Peter can be contacted via phone (707) 526-2020.

Contact Information

Primary practice address
2320 Midway Dr Santa Rosa CA 95405-5017
Phone: (707) 526-2020
Fax: (707) 526-2032
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X CA5653T California

Profile Details

NPI number 1114088796
LBN Legal business name Disalvo, Peter
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2006
Last updated Mar 27th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114088796 NPPES
California MEDICAID SD0056530

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