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Contact Information

EDGAR A PERALTA, PA-C
725 WELCH RD
PALO ALTO, CA94304-1601
 Phone: 650-497-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for EDGAR A PERALTA · (Male)

NPI # 1619345899
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 09/04/2015
Last updated 07/23/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 63754
  • FL License # PA9108951
Hospital affiliation(s)
  • MEMORIAL HOSPITAL WEST - (Acute Care)
    703 N FLAMINGO RD
    PEMBROKE PINES, FL 33028
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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