Provider Demographics
NPI:1407738107
Name:PEAK HEALTH MEDICAL GROUP OF CALIFORNIA PC
Entity type:Organization
Organization Name:PEAK HEALTH MEDICAL GROUP OF CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EDNIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, RD
Authorized Official - Phone:408-203-7959
Mailing Address - Street 1:810 BEAR GULCH RD
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-4430
Mailing Address - Country:US
Mailing Address - Phone:408-203-7959
Mailing Address - Fax:
Practice Address - Street 1:3388 17TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-7201
Practice Address - Country:US
Practice Address - Phone:408-203-7959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty