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Individual

PETER LOSEV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C. PED

Contact information

Practice address
1622 WEBSTER ST, ALAMEDA, CA 94501-2134
(510) 523-4316
Mailing address
1622 WEBSTER ST, ALAMEDA, CA 94501-2134
(510) 523-4316

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3265
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DME02996F
CA
Enumeration date
05/27/2006
Last updated
08/27/2020
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