Organization
RYAN C PETERSON MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN C PETERSON MD (DIRECT OWNER)
(310) 266-3774
Entity
Organization
Contact information
Practice address
3209 HILLOCK DR, LOS ANGELES, CA 90068-1427
(310) 266-3774
(323) 380-7420
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A103097
CA
Other
Enumeration date
04/12/2011
Last updated
02/10/2020
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