Petersen, Jeffrey
Petersen, Jeffrey is an individual health care provider with primary practice located at 300 Pasteur Dr # A175Mc5309 , Stanford CA 94305-2200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Petersen, Jeffrey can be contacted via phone (650) 723-1151.Contact Information
Primary practice address
300 Pasteur Dr # A175Mc5309
Stanford CA 94305-2200
Phone: (650) 723-1151
Fax: (650) 723-7917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | A36290 | California |
Profile Details
| NPI number | 1649312752 |
|---|---|
| LBN Legal business name | Petersen, Jeffrey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649312752 | NPPES |
| California | MEDICAID | 00A362900 |
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