Individual
MICHAEL PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2830 TUSCALOOSA ST, SAN DIEGO, CA 92110-4264
(602) 502-4991
Mailing address
2830 TUSCALOOSA ST, SAN DIEGO, CA 92110-4264
(602) 502-4991
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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