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Individual

KENNETH MICHAEL PITERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1383 N MCDOWELL BLVD, PETALUMA, CA 94954-1187
(707) 544-7331
(707) 623-9409
Mailing address
PO BOX 6671, SANTA ROSA, CA 95406-0671
(707) 544-7331
(707) 623-9409

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G29348
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G293481
CA
Enumeration date
07/27/2006
Last updated
04/03/2017
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