Provider Demographics
NPI:1386694040
Name:PIAMPIANO, PETER PAUL (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:PAUL
Last Name:PIAMPIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14005
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-1405
Mailing Address - Country:US
Mailing Address - Phone:714-571-5000
Mailing Address - Fax:714-571-5055
Practice Address - Street 1:2240 SUTHERLAND AVE STE 107
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2333
Practice Address - Country:US
Practice Address - Phone:865-584-7376
Practice Address - Fax:865-540-3856
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA675232085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A675230OtherBLUE SHIELD
P00267752OtherRAILROAD MEDICARE
CA00A675230Medicaid
WA67523JMedicare PIN
WA67523HMedicare PIN
H51651Medicare UPIN
P00267752OtherRAILROAD MEDICARE
WA67523KMedicare PIN
WA67523GMedicare PIN