Kenneth a Peterson
NPI #1235371782 in Pismo Beach, California
Provider Information
- NPI Number
- 1235371782
- Entity Type
- Organization
- Organization Name
- Kenneth a Peterson
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Mar 30, 2009
- Last Updated
- Mar 30, 2009
Practice Location
- Address
- 911 OAK PARK BLVD STE 104
- City
- Pismo Beach
- State
- California
- ZIP Code
- 93449-3406
- Phone
- (805) 473-9393
Authorized Official
- Name
- DR. KENNETH PETERSON, OD
- Title
- OWNER
- Phone
- (805) 473-9393
Specialties & Taxonomy Codes
| Specialty |
|---|
| Eyewear Supplier |
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