# PENINSULA EYE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1780571877
- **Authorized official:** JUDITH NEVITT MD (OWNER)
- **Authorized official phone:** (650) 324-0056

## Contact information

- **Practice address:** 1391 WOODSIDE RD STE 200, REDWOOD CITY, CA 94061-3574
- **Practice address phone:** (650) 324-0056
- **Mailing address:** 1391 WOODSIDE RD STE 200, REDWOOD CITY, CA 94061-3574
- **Mailing address phone:** (650) 324-0056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2025
- **Last updated:** 06/20/2025