# DENNIS A PETERSEN D.O. INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326265083
- **Authorized official:** DENNIS ALAN PETERSEN D.O. (DOCTOR)
- **Authorized official phone:** (951) 506-3112

## Contact information

- **Practice address:** 27403 YNEZ RD, SUITE 103, TEMECULA, CA 92591-5603
- **Practice address phone:** (951) 506-3112
- **Practice address fax:** (951) 506-3116
- **Mailing address:** 27403 YNEZ RD, SUITE 103, TEMECULA, CA 92591
- **Mailing address phone:** (951) 506-3112
- **Mailing address fax:** (951) 506-3116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 20A4978 | CA | Yes |

## Other

- **Enumeration date:** 04/20/2007
- **Last updated:** 08/22/2020