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Individual

DR. CARL DAVID PETERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9735 OAK LEAF WAY, GRANITE BAY, CA 95746-8921
(916) 521-1379
Mailing address
9735 OAK LEAF WAY, GRANITE BAY, CA 95746-8921
(916) 521-1379

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G18463
CA

Other

Enumeration date
05/21/2019
Last updated
05/21/2019
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