Active NPI
Robert Steven Peck, M.D.
- Anesthesiology Physician
- Orange, CA
National Provider Identifier
1730100256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G62779
- Practice address
- 1100 W Stewart Dr
Orange, CA 92868-3849 - Phone
- (714) 633-9111
- Fax
- (714) 744-8695
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G62779 | CA | Primary |
Addresses
Primary practice location
1100 W Stewart Dr
Orange, CA 92868-3849
Mailing address
PO Box 1628
Orange, CA 92856-0628
Phone (714) 619-4730
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G627790 | Other | CA | BLUE SHIELD |
| 00G627790 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62779 | CA | MD | Pharmacist |
| G62779 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241481600000",
"number": "1730100256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1628",
"city": "ORANGE",
"state": "CA",
"postal_code": "928560628",
"telephone_number": "714-619-4730",
"fax_number": "714-560-1585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W STEWART DR",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683849",
"telephone_number": "714-633-9111",
"fax_number": "714-744-8695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "ROBERT",
"middle_name": "STEVEN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2009-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G62779",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G627790",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G627790",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
- Simone Pearson
- Jonathan Michael Peaslee
- Spring Medley Peavy, FNP-C
- Georgie Joven Pechulis, M.D,
- Martha M Peck, CRNA
- Pediatric Eye Care & Surgery Medical Corporation
- Pediatric Subspecialty Faculty
- Pediatric Subspecialty Faculty, Inc.
- Pediatric Subspecialty Faculty, Inc.
- Pediatric Subspecialty Faculty, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.