Individual
ROY C. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 WEST E STREET, TEHACHAPI, CA 93581-1900
(661) 972-2874
(661) 823-8106
Mailing address
20322 OAKDALE LN, TEHACHAPI, CA 93561-7649
(661) 972-2874
(661) 823-8106
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
G036719
CA
207QA0505X
Adult Medicine Physician
G036719
CA
Other
Enumeration date
02/23/2009
Last updated
03/19/2014
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