Doctor Name: | PETER HEINEN |
NPI Number: | 1427096643 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | PA10565 |
Business Practice Address: | 6010 Hidden Valley Rd Ste 200 Carlsbad, CA - 920114219 |
Business Phone Number: | 7606313000 |
Business Fax Number: | 7606313016 |
Mailing Address: | 6010 Hidden Valley Rd Ste 200, CARLSBAD |
State: | CA |
Postal Code: | 920114219 |
Phone Number: | 7606313000 |
Fax Number: | 7606313016 |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 01/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | PA10565 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |