PETER GANNON MD
NPI 1275560286
Specialist in Stockton, CA

Q: What is Peter Gannon's NPI number?

The NPI number for Peter Gannon is 1275560286. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Q: What is Peter Gannon's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Peter Gannon was last updated on August 4, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 26, 2006

545 E CLEVELAND ST, SUITE B, STOCKTON, CA 95204(209) 948-0205(209) 948-0245 Get Directions Write a Review

NPPES record last updated: August 4, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Peter Gannon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETER GANNON MD (NPI 1275560286) is an individual specialist in Stockton, California, licensed in California (G25472) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1275560286

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NamePETER GANNONCredential: MD

Location Address545 E CLEVELAND ST, SUITE BStockton, CA 95204-5535

Mailing Address545 E Cleveland St, Suite BStockton, CA 95204-5535 · (209) 948-0205 · Fax (209) 948-0245

Phone(209) 948-0205

Fax(209) 948-0245

Sole ProprietorYes

Enumeration DateJune 26, 2006

Last NPPES UpdateAugust 4, 2010

✔ NPI 1275560286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · G25472

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

545 E CLEVELAND ST, Stockton, CA 95204

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Other Identifiers 1

Medicare UPINA42678CA

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAI CARE CENTERS OF NORTHERN CALIFORNIA I, LLC

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)

545 E CLEVELAND ST
STOCKTON, CA 95204

San Joaquin County (209) 943-0854

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peter Gannon's NPI number?

The NPI number for Peter Gannon is 1275560286. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Where is Peter Gannon located?

Peter Gannon practices at 545 E Cleveland St Suite B, Stockton, CA 95204. The listed phone number is (209) 948-0205.

What is Peter Gannon's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Peter Gannon was last updated on August 4, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.