Organization
PENINSULA LASER EYE MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J. BEERS M.D. (OWNER)
(650) 961-2585
Entity
Organization
Contact information
Practice address
1174 CASTRO ST, SUITE 100, MOUNTAIN VIEW, CA 94040-2568
(650) 961-2585
(650) 961-6527
Mailing address
1174 CASTRO ST, SUITE 100, MOUNTAIN VIEW, CA 94040-2568
(650) 961-2585
(650) 961-6527
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK5784
RAILROAD MEDICARE
—
05
—
GR0093380
—
CA
01
—
ZZZ05868Z
BLUE SHIELD CA
—
Enumeration date
12/14/2006
Last updated
01/06/2015
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