| Doctor Name: | MR. RANDY L PETERS |
| NPI Number: | 1265441216 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 3198 W 7th St Apt 318 Los Angeles, CA - 900051659 |
| Business Phone Number: | 2134272950 |
| Business Fax Number: | 2134272950 |
| Mailing Address: | 3198 W 7th St Apt 318, LOS ANGELES |
| State: | CA |
| Postal Code: | 900051659 |
| Phone Number: | 2134272950 |
| Fax Number: | 2134272950 |
| NPI Enumeration Date: | 08/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332900000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Non-Pharmacy Dispensing Site |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |