Individual
MR. WILLIAM CHARLES PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161-0002
(858) 642-1012
Mailing address
12110 PASTORAL RD, SAN DIEGO, CA 92128-2632
(858) 674-6524
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 18006
CA
Other
Enumeration date
06/07/2006
Last updated
07/08/2007
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