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NPI Code Detail

MEDICARE: TONYE PETERS

MEDICARE:   TONYE  PETERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11710I1002XIndependent Duty Corpsman

General Provider Information

NPI Number : 1265392013
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYE PETERS
Provider Business Mailing Address
First Line : 2961 E ST APT 2
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2526
Country : US
Telephone Number : 334-940-5090
Fax Number :
Provider Business Practice Location Address
First Line : 2961 E ST APT 2
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2526
Country : US
Telephone Number : 334-940-5090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2025
Last Update Date : 11/14/2025

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Directions to “ TONYE PETERS ” Practice Location

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