Search › California › 207RP1001X
Glen Petersen, M.D
NPI 1467495986 · on the registry since 2006
Practice
- Address
- 411 30th St
Suite 314
Oakland, CA 94609 - Phone
- (510) 465-6800
- Fax
- (510) 268-0634
- Organisation at this address
- Dynamedic Drugs Inc
Bay Area Foot Care, Inc
East Bay Pain Care, Inc.
Luminous Mind Medicine Inc.
Steven R. Young, Ocularist, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 62
Registry record
- Primary taxonomy
- 207RP1001X
207RP1001X
- Also registered as
- 207RC0200X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-01-14
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California