Individual
DR. CHARLES CAPDEVILLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
544 N GLENDALE AVE STE B, GLENDALE, CA 91206-3311
(747) 212-3441
Mailing address
2100 POWELL ST STE 400, EMERYVILLE, CA 94608-1826
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A15085
CA
Other
Enumeration date
11/25/2016
Last updated
01/26/2021
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