| Organization Name: | DENNIS A PETERSEN D.O. INC |
| NPI Number: | 1326265083 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENNIS ALAN PETERSEN (DOCTOR) |
| Mailing Address: | 27403 Ynez Rd Suite 103 Temecula |
| State: | CA US |
| Postal Code: | 925915603 |
| Phone Number: | 9515063112 |
| Fax Number: | 9515063116 |
| NPI Enumeration Date: | 04/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A4978 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |