Individual
DERRICK SCHUYLER PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 BRADSHAW RD, SUITE A-5, SACRAMENTO, CA 95827-2614
(916) 415-8648
Mailing address
PO BOX 518, RANCHO CORDOVA, CA 95741-0518
(916) 402-2731
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/31/2012
Last updated
10/02/2013
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