Individual
KAREN LINNEA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
960 E GREEN ST STE 208, PASADENA, CA 91106-2401
(424) 314-0196
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A53128
CA
207Y00000X
Otolaryngology Physician
MD00036232
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039572
LABOR & INDUSTRY
WA
01
—
040014303
RAILROAD MEDICARE
—
05
—
8230948
—
WA
01
—
MD5018W
ALASKA MEDICAID
WA
01
—
PE3331
BLUE SHIELD
WA
01
—
US1037408
AETNA/USHC SPECIALIST
WA
Enumeration date
08/14/2006
Last updated
12/06/2023
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