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Jack Peak
NPI 1043594013 · on the registry since 2011
Practice
- Address
- 11665 Laurel Ave
Loma Linda, CA 92354 - Phone
- (909) 838-2679
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-10-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California