Individual
DR. CAROLYN PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
509 LITHO ST, SAUSALITO, CA 94965-1833
(415) 521-0481
Mailing address
1001 BRIDGEWAY, #707, SAUSALITO, CA 94965-2104
(415) 521-0481
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G32490
CA
207RI0200X
Infectious Disease Physician
G32490
CA
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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