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Individual

DR. NANCY LYNN PETERSILGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1529 ARBOR AVE, LOS ALTOS, CA 94024-5914
(650) 941-0890
Mailing address
1529 ARBOR AVE, LOS ALTOS, CA 94024-5914
(650) 941-0890

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G44365
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G44365
CALIFORNIA DEPARTMENT CONSUMER AFFAIRS
CA
Enumeration date
08/21/2008
Last updated
08/21/2008
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