Healthcare Provider Details

I. General information

NPI: 1295997047
Provider Name (Legal Business Name): CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 CAMINO DEL MAR SUITE F
DEL MAR CA
92014-2553
US

IV. Provider business mailing address

7485 MISSION VALLEY RD SUITE #104A
SAN DIEGO CA
92108-4422
US

V. Phone/Fax

Practice location:
  • Phone: 619-291-8930
  • Fax:
Mailing address:
  • Phone: 619-291-8930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DREW ALAN PETERSON
Title or Position: PARTNER
Credential: M.D.
Phone: 619-291-8930