Petersen, Richard Nels
Petersen, Richard Nels is an individual health care provider with primary practice located at 1745 W Avenue K Suite A, Lancaster CA 93534-6502. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Petersen, Richard Nels can be contacted via phone (661) 942-8437.Contact Information
Primary practice address
1745 W Avenue K Suite A
Lancaster CA 93534-6502
Phone: (661) 942-8437
Fax: (661) 940-1959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 13129 | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0PT13129T | California |
Profile Details
| NPI number | 1407867161 |
|---|---|
| LBN Legal business name | Petersen, Richard Nels |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Dec 23rd, 2008 - about 16 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 | 1407867161 | NPPES |
| California | Other | SD13129T0 | BLUECROSS/BLUE SHIELD |
| California | Other | 14156 | BLUECROSS/BLUE SHIELD |
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