Individual
DR. MARK ARTHUR PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 S ELISEO DR, STE 104, GREENBRAE, CA 94904-2023
(415) 461-7955
(415) 927-8858
Mailing address
438 RIVIERA CIR, LARKSPUR, CA 94939-1510
(415) 461-7955
(415) 927-8858
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C40987
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C409870
—
CA
01
—
020006844
RAILROAD MEDICARE
CA
Enumeration date
06/09/2006
Last updated
10/05/2012
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