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:
Health care specialties
| Specialty | Code | License # | 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 3 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 | 1114088796 | NPPES |
| California | MEDICAID | SD0056530 |
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