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General NPI Number Information
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NPI Number | 1841236072
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Entity Type | Individual
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Provider Name | WILLIAM JAMES PETERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | VACAVALLEY HOSPITAL 1000 NUT TREE ROAD
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City | VACAVILLE
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State | CA
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Zip | 95687
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Country | US
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Telephone | 707-446-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 SHANNON CT
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City | BENICIA
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State | CA
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Zip | 94510-2737
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Country | US
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Telephone |
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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 | G56798
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License Number State | CA
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