PETER D GLUSKER (NPI# 1902803406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902803406 |
| Entity Type | Individual |
| Full Name | PETER D GLUSKER |
| Credential | M.D.-PH.D. |
| Practice Address |
442 N Mcpherson St Fort Bragg CA 95437-3314 |
| Mailing Address |
Po Box 1639 Fort Bragg CA 95437-1639 |
| Practice Telephone | 7079646624 |
| Practice Fax Number | 7079646624 |
| Mailing Telephone | 7079646624 |
| Mailing Fax Number | 7079646624 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2016-06-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
G30601 | CA | Allopathic & Osteopathic Physicians |
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
G30601 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CA STATE LICENSE | G30601 | 01 |
| CA | 1469118 | 05 | |
| WA | WASHINGTON STATE MEDICAL | MD00016563 | 01 |
| CA | MEDICARE LEGACY PROVIDER | 00G306010 | 01 |
| OR | OREGON STATE MEDICAL LICE | 11173 | 01 |
| Street Address |
442 N MCPHERSON ST |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-3314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346299799 | Benjamin Ethan Solomon | Psychiatry & Neurology | Neurology Service, Dep't of Medicine, Womack Army Medical Center, Fort Bragg, NC 28310-0001 | 2006-05-10 |
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| 1609415314 | Aspire Holdings, Inc | Psychiatry & Neurology | 28212 Kelly Johnson Pkwy Ste 215, Valencia, CA 91355-5090 | 2019-12-27 |
| 1336785187 | Tp-health Ca PC | Psychiatry & Neurology | 201 E Center St Ste 112, Anaheim, CA 92805-7212 | 2019-11-26 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.