Provider Demographics
NPI:1154615482
Name:PEIKOFF, MICHAEL MARSHAL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:MARSHAL
Last Name:PEIKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7040 AVENIDA ENCINAS
Mailing Address - Street 2:104-183
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011
Mailing Address - Country:US
Mailing Address - Phone:702-277-1005
Mailing Address - Fax:760-448-6720
Practice Address - Street 1:7040 AVENIDA ENCINAS
Practice Address - Street 2:104-183
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011
Practice Address - Country:US
Practice Address - Phone:702-277-1005
Practice Address - Fax:760-448-6720
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG11226208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics