Novota, Peter Allen

Novota, Peter Allen is an individual health care provider with primary practice located at 3110 Kerner Blvd , San Rafael CA 94901-5411. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Novota, Peter Allen can be contacted via phone (415) 448-1500.

Contact Information

Primary practice address
3110 Kerner Blvd San Rafael CA 94901-5411
Phone: (415) 448-1500
Fax: (415) 526-8570
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G156549 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036091570 Illinois

Profile Details

NPI number 1124132394
LBN Legal business name Novota, Peter Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Aug 8th, 2019 - 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 1124132394 NPPES
Illinois MEDICAID 036091570

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