Peterson, Michael Blair

Peterson, Michael Blair is an individual health care provider with primary practice located at 2500 Merced St , San Leandro CA 94577-4201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Peterson, Michael Blair can be contacted via phone (510) 454-1000.

Contact Information

Primary practice address
2500 Merced St San Leandro CA 94577-4201
Phone: (510) 454-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X G45972 California
Allopathic & Osteopathic Physicians / Surgery 208600000X G45972 California

Profile Details

NPI number 1255419024
LBN Legal business name Peterson, Michael Blair
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255419024 NPPES
California MEDICAID 00G459720

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