| B D Peterson Md Inc | |
|
2390 Jackson Ave Escalon CA 95320-2078 | |
| (209) 838-6015 | |
| (209) 838-0750 |
| Full Name | B D Peterson Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2390 Jackson Ave, Escalon, California |
| Authorized Official Name and Position | Bob D Peterson (PRESIDENT) |
| Authorized Official Contact | 2098386015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| B D Peterson Md Inc 2390 Jackson Ave Escalon CA 95320-2078 Ph: (209) 838-6015 | B D Peterson Md Inc 2390 Jackson Ave Escalon CA 95320-2078 Ph: (209) 838-6015 |
| NPI Number | 1114232204 |
|---|---|
| Provider Enumeration Date | 08/12/2010 |
| Last Update Date | 08/12/2010 |
| Medicare PECOS PAC ID | 4587788781 |
|---|---|
| Medicare Enrollment ID | O20100825000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114232204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G66903 (California) | Primary |
| Provider Name | Bobby D Peterson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841359171 PECOS PAC ID: 1951380567 Enrollment ID: I20040726000600 |
Krishnamoorthi M. D. Inc., A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 850 California St, Escalon, CA 95320 Phone: 209-838-2278 | |
Escalon Community Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2080 Mchenry Ave # 100, Escalon, CA 95320 Phone: 209-847-3011 Fax: 209-848-4110 |