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Contact Information

PETER K MANSURIPUR, MD
975 SERENO DR
VALLEJO, CA94589
 Phone: 707-651-2549
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hand Surgery

207XS0106X 02 Physician/General Surgery
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PETER K MANSURIPUR · (Male)

NPI # 1588984306
Status Active
Credentials MD
Entity Individual
Enumeration date 06/03/2010
Last updated 02/11/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A140883
  • RI License # 14894
  • RI License # LP01956
  • RI Medicaid 1588984306
Hospital affiliation(s)
  • KAISER FOUNDATION HOSPITAL - VACAVILLE - (Acute Care)
    1 QUALITY DRIVE
    VACAVILLE, CA 95688
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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