Individual
JEFFREY MING PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10833 LE CONTE AVE, 13-145A CENTER FOR HLTH SCI, LOS ANGELES, CA 90095-3075
(626) 274-6485
Mailing address
3900 WOODLAND AVE, DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE, PHILADELPHIA, PA 19104
(626) 274-6485
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
MD459596
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD459596
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/02/2012
Last updated
11/16/2018
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