Individual
SOFIA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
33758 YUCAIPA BLVD, YUCAIPA, CA 92399-2243
(909) 795-9747
Mailing address
33758 YUCAIPA BLVD, YUCAIPA, CA 92399-2243
(714) 443-4512
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A76621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A766210
—
CA
Enumeration date
07/20/2006
Last updated
03/22/2024
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