Provider Demographics
NPI:1801672266
Name:PEAK POTENTIAL, LLC
Entity type:Organization
Organization Name:PEAK POTENTIAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DISANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-422-2691
Mailing Address - Street 1:3152 RED HILL AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3418
Mailing Address - Country:US
Mailing Address - Phone:949-422-2691
Mailing Address - Fax:
Practice Address - Street 1:3152 RED HILL AVE STE 130
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3418
Practice Address - Country:US
Practice Address - Phone:949-422-2691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center