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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 12 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 1215918784 NPPES
Illinois MEDICAID 036102822

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