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General NPI Number Information
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NPI Number | 1811351562
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Entity Type | Individual
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Provider Name | FREYR PETURSSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 1000 W CARSON ST
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City | TORRANCE
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State | CA
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Zip | 90502-2004
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Country | US
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Telephone | 310-222-2912
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Fax |
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Provider Business Mailing Address
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Address Line | 2340 LAFAYETTE AVE APT 1D
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City | SAINT LOUIS
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State | MO
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Zip | 63104-2516
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Country | US
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Telephone | 858-525-2918
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A153519
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License Number State | CA
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