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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KENNETH A PETERSON, OD

Active Sole Proprietor

DR. KENNETH A PETERSON, OD is a Optometrist healthcare provider located in PISMO BEACH, California. NPI 1871565788 is currently active in the NPPES registry. Verify at CMS.

Optometrist · PISMO BEACH, CA

Registration Details

NPI Number
1871565788
Provider Type
Individual
Gender
Male
NPI Issued
Feb 3, 2006 (20.344242522185 yrs)
Last Updated
Feb 6, 2008
License
9884T (CA)
Sole Proprietor
Yes

Practice Information

Address
911 OAK PARK BLVD STE 104
PISMO BEACH, CA, 934493406
Browse CA providers · Browse ZIP 93449
Phone
8054739393
Fax
8054731974
Primary Specialty
Optometrist
152W00000X

Other Optometrist Providers in PISMO BEACH, CA

Name Credential NPI
SCOTT ERIC SCHACHTER O.D. 1447230602
MICHAEL E. JACOBS O.D. 1821101684
DR. MONA KAUR GILL O.D. 1477856003
DR. DENNIS RAOUL RICHARDSON O.D. 1588931398
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.