Individual
DR. PETER DIETZE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10243 GENETIC CENTER DR, SAN DIEGO, CA 92121-6310
(858) 499-2702
(858) 526-6113
Mailing address
10243 GENETIC CENTER DR, SAN DIEGO, CA 92121-6310
(858) 499-2702
(858) 526-6113
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G 79877
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G 798770
—
CA
Enumeration date
08/30/2006
Last updated
06/18/2013
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