# PENINSULA OBGYN INTEGRATIVE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669957114
- **Authorized official:** DR. SAMUEL YOUNG MD (PRESIDENT)
- **Authorized official phone:** (650) 281-8716

## Contact information

- **Practice address:** 101 S SAN MATEO DR STE 111, SAN MATEO, CA 94401-3840
- **Practice address phone:** (650) 542-0092
- **Practice address fax:** (650) 389-6960
- **Mailing address:** 205 DE ANZA BLVD \# 72, SAN MATEO, CA 94402-3989
- **Mailing address phone:** (650) 281-8716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2018
- **Last updated:** 08/19/2019