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Individual

DR. DOUGLAS CHARLES PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9260 LAGUNA SPRINGS DR, SUITE E2-308, ELK GROVE, CA 95758-7947
(916) 691-9574
Mailing address
PO BOX 588500, SUITE E2-308, ELK GROVE, CA 95758-8500
(916) 691-9574

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G42408
CA
208D00000X
General Practice Physician
Primary
G42408
CA
209800000X
Legal Medicine (M.D./D.O.) Physician
G42408
CA

Other

Enumeration date
05/15/2007
Last updated
04/22/2013
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