Peralta, Elizabeth A
Peralta, Elizabeth A is an individual health care provider with primary practice located at 3883 Airway Drive Suite 201, Santa Rosa CA 95403-1671. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Peralta, Elizabeth A can be contacted via phone (707) 521-8900.Contact Information
Primary practice address
3883 Airway Drive Suite 201
Santa Rosa CA 95403-1671
Phone: (707) 521-8900
Fax: (707) 523-1309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | G83732 | California |
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | 036102822 | Illinois |
Profile Details
| NPI number | 1215918784 |
|---|---|
| LBN Legal business name | Peralta, Elizabeth A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Jan 6th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215918784 | NPPES |
| Illinois | MEDICAID | 036102822 |
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