Doctor Name: | MR. STEPHEN DEXTER PETERSON |
NPI Number: | 1992897771 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A31968 |
Business Practice Address: | 185 E. 7th Ave. Suite D Chico, CA - 95926 |
Business Phone Number: | 5303427564 |
Business Fax Number: | 5303427585 |
Mailing Address: | 185 East 7th Ave., Suite D CHICO |
State: | CA |
Postal Code: | 95926 |
Phone Number: | 5303427564 |
Fax Number: | 5303427585 |
NPI Enumeration Date: | 09/29/2006 |
NPI Last Update Date: | 09/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A31968 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |