Individual
ROBERT E PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, M.D
Contact information
Practice address
8008 FROST ST, SUITE 304, SAN DIEGO, CA 92123-4205
(858) 874-0248
(858) 874-0667
Mailing address
8008 FROST ST, SUITE 304, SAN DIEGO, CA 92123-4205
(858) 874-0248
(858) 874-0667
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
A63776
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A637760
BLUE SHIELD
CA
Enumeration date
08/30/2006
Last updated
11/05/2021
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