Mazzarese, Peter M.

Mazzarese, Peter M. is an individual health care provider with primary practice located at 5555 Reservoir Dr Ste 203 , San Diego CA 92120-5115. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mazzarese, Peter M. can be contacted via phone (619) 229-3340.

Contact Information

Primary practice address
5555 Reservoir Dr Ste 203 San Diego CA 92120-5115
Phone: (619) 229-3340
Fax: (619) 229-3341
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA16565 California

Profile Details

NPI number 1124099387
LBN Legal business name Mazzarese, Peter M.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Dec 13th, 2021 - about 4 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 1124099387 NPPES
California MEDICAID PA16565

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