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Individual
DR. PETER V HETZNER
Active
Individual
DR. PETER V HETZNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5692TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622870001
CIGNA MEDICARE
CA
05
—
SD0056920
—
CA
01
—
ZZZ28009Z
BLUE SHIELD
CA
Enumeration date
11/07/2005
Last updated
03/01/2013
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