Pedro Luis Estacio, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

G068986 Issued in CA

Practice address

7000 East Ave
Building 663 HSD
Livermore, CA 94550-9698

Phone

(925) 525-4523

NPI assigned

Dec 28, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Peter Luis Estacio Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1710256250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3333",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945390333",
            "telephone_number": "925-423-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 EAST AVE",
            "address_2": "BUILDING 663 HSD",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945509698",
            "telephone_number": "925-525-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTACIO",
        "first_name": "PEDRO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G068986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETER",
            "last_name": "ESTACIO",
            "middle_name": "LUIS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric D. Luu & Lisa M. Nguyen
• Lynsie Erickson-Facca
• Rita Jean Escalante
• Alanna Esquejo, LMFT
• Mohsain Essa, M.D.
• Parinaz Esteghamat Tehrani, DDS
• Daisy Arabelle Soriben Evangelista, PHARM.D.
• Nancy A. Everett, MD
• Evergreen Island, LLC
• Reece Everson, DPM

• Specialist in Livermore, CA
• Providers in Livermore, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.