Individual
MR. JEFFERY ALLEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 248-9666
Mailing address
4428 TOPA TOPA DR, LA MESA, CA 91941-7160
(619) 248-9666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
799556
CA
Other
Enumeration date
12/26/2012
Last updated
12/26/2012
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