Provider Demographics
NPI:1992869226
Name:DAVIS, PETER K (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:K
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:K
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1691 EL CAMINO REAL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1053
Mailing Address - Country:US
Mailing Address - Phone:650-326-8600
Mailing Address - Fax:650-521-0456
Practice Address - Street 1:1691 EL CAMINO REAL
Practice Address - Street 2:SUITE 400
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1053
Practice Address - Country:US
Practice Address - Phone:650-326-8600
Practice Address - Fax:650-521-0456
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76574208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG76574OtherCA MEDICAL LICENSE
CAG076574OtherCA MEDICAL LICENSE
CAG076574OtherCA MEDICAL LICENSE
CAG62773Medicare UPIN