Individual
DR. MARY C GESSNER-PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2710 ALPINE BLVD # 205, ALPINE, CA 91901-2276
(619) 326-4445
Mailing address
2710 ALPINE BLVD, ALPINE, CA 91901-2276
(619) 326-4445
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
OS014103
PA
207R00000X
Internal Medicine Physician
20A1174
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
825521721
URGENT CARE TAX ID
CA
Enumeration date
03/05/2008
Last updated
09/26/2018
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