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Organization
T K PETERSON MD
Active
Organization
T K PETERSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS KIMBALL PETERSON MD (PRESIDENT)
(310) 638-5119
Entity
Organization
Contact information
Practice address
3617 MLK BOULEVARD SUITE 1, LYNWOOD, CA 90262
(310) 638-5119
(310) 635-0738
Mailing address
3617 MLK BLVD, LYNWOOD, CA 90262
(310) 638-5119
(310) 635-0738
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A26295
CA
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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