Individual
DR. ROBERT J PERALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
491 30TH ST, SUITE 103, OAKLAND, CA 94609-3235
(510) 763-0881
(510) 763-0907
Mailing address
491 30TH ST, SUITE 103, OAKLAND, CA 94609-3235
(510) 763-0881
(510) 763-0907
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01068178A
IN
207W00000X
Ophthalmology Physician
Primary
35.095215
OH
207W00000X
Ophthalmology Physician
TP122
KY
390200000X
Student in an Organized Health Care Education/Training Program
242440
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000655173
BCBS
OH
Enumeration date
06/15/2007
Last updated
02/11/2022
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