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NPI Code Detail

MEDICARE: DR. ANDREW ERIC PETERSON DC

MEDICARE:  DR. ANDREW ERIC PETERSON  DC
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
1111N00000XChiropractorDC 16477CA

General Provider Information

NPI Number : 1144337338
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW ERIC PETERSON DC
Provider Business Mailing Address
First Line : 1251 SHELL BEACH RD
Second Line : PO BOX 3407
City : PISMO BEACH
State : CA
Zip : 93449
Country : US
Telephone Number : 805-773-1251
Fax Number : 804-773-3961
Provider Business Practice Location Address
First Line : 1251 SHELL BEACH RD
Second Line :
City : PISMO BEACH
State : CA
Zip : 93449
Country : US
Telephone Number : 805-773-1251
Fax Number : 804-773-3961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 05/07/2008

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Directions to “ DR. ANDREW ERIC PETERSON DC” Practice Location

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