Individual
JOHN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23649 CASTLE ROCK, MISSION VIEJO, CA 92692-1897
(949) 923-0554
Mailing address
23649 CASTLE ROCK, MISSION VIEJO, CA 92692-1897
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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