Individual
RICHARD BERTRAM PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1661 SOQUEL DR, BUILDING G, SANTA CRUZ, CA 95065-1709
(831) 476-1542
(831) 464-8977
Mailing address
1661 SOQUEL DR, BUILDING G, SANTA CRUZ, CA 95065-1709
(831) 476-1542
(831) 464-8977
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G28341
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G283410
—
CA
Enumeration date
07/28/2006
Last updated
05/09/2008
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