Individual
CHRISTOPHER RUSSELL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDEPENDENT DUTY CORP
Contact information
Practice address
909 ASH RD, OCEANSIDE, CA 92058-8664
(818) 404-4527
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-7968
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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