Peterson, Bart J

Peterson, Bart J is an individual health care provider with primary practice located at 3 Medical Plaza Dr Ste 140 , Roseville CA 95661-3088. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Peterson, Bart J can be contacted via phone (916) 865-1400.

Contact Information

Primary practice address
3 Medical Plaza Dr Ste 140 Roseville CA 95661-3088
Phone: (916) 865-1400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA723 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA21631 California

Profile Details

NPI number 1619150752
LBN Legal business name Peterson, Bart J
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2007
Last updated Apr 26th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619150752 NPPES
Idaho Other PA723 LICENSE NUMBER

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