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1780248146
MICHAEL JAKE PETERSEN
SACRAMENTO, CA
NPI
1780248146
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208000000X Pediatrics
(Licence: CA A191321)
Enumeration Date
2019-04-30
Last Update Date
2024-06-26
Business Address
MICHAEL JAKE PETERSEN
2516 STOCKTON BLVD
SACRAMENTO, CA 95817-2208
Phone number: 916-734-2105
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Mailing Address
MICHAEL JAKE PETERSEN
2516 STOCKTON BLVD
SACRAMENTO, CA 95817-2208
Phone number:
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