Provider Demographics
NPI:1861638710
Name:PETER M. JAMIESON, M.D., INC
Entity type:Organization
Organization Name:PETER M. JAMIESON, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAMIESON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-866-0011
Mailing Address - Street 1:555 E TACHEVAH DR
Mailing Address - Street 2:SUITE 1W-201
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5750
Mailing Address - Country:US
Mailing Address - Phone:760-866-0011
Mailing Address - Fax:760-866-0012
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:SUITE 1W-201
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5750
Practice Address - Country:US
Practice Address - Phone:760-866-0011
Practice Address - Fax:760-866-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53447174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty