Individual
TODD BAILEY PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-7577
(619) 532-7673
Mailing address
197 CARNATION AVE, IMPERIAL BEACH, CA 91932-1007
(619) 423-4972
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G83455
CA
208C00000X
Colon & Rectal Surgery Physician
Primary
G83455
CA
Other
Enumeration date
06/22/2005
Last updated
09/11/2025
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