Organization
KENNETH PERCY PETERSON, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH PERCY PETERSON MD (PRESIDENT)
(805) 796-4595
Entity
Organization
Contact information
Practice address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
Mailing address
12155 MESQUITE ST, OAK HILLS, CA 92344-7903
(805) 796-4595
(760) 662-5711
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
C50553
CA
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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