Individual
PROF. JEFFREY PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 PASTEUR DR # A175MC5309, STANFORD, CA 94305-2200
(650) 723-1151
(650) 723-7917
Mailing address
300 PASTEUR DR # A175MC5309, STANFORD, CA 94305-2200
(650) 723-1151
(650) 723-7917
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A36290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A362900
—
CA
Enumeration date
02/13/2007
Last updated
07/08/2007
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