Provider Demographics
NPI:1427481522
Name:PETER ADAMCZYK, MD, INC.
Entity type:Organization
Organization Name:PETER ADAMCZYK, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:R
Authorized Official - Last Name:ADAMCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-538-7738
Mailing Address - Street 1:20055 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5331
Mailing Address - Country:US
Mailing Address - Phone:510-538-7738
Mailing Address - Fax:510-738-7777
Practice Address - Street 1:20055 LAKE CHABOT RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5331
Practice Address - Country:US
Practice Address - Phone:510-538-7738
Practice Address - Fax:510-538-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA984612084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty