KENNETH PERCY PETERSON, MD, INC. (NPI# 1184015380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184015380 |
| Entity Type | Organization |
| Organization Name | KENNETH PERCY PETERSON, MD, INC. |
| Practice Address |
16850 Bear Valley Rd Victorville CA 92395-5794 |
| Mailing Address |
12155 Mesquite St Oak Hills CA 92344-7903 |
| Practice Telephone | 7602418000 |
| Mailing Telephone | 8057964595 |
| Mailing Fax Number | 7606625711 |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |
| Authorized Official Name | DR. KENNETH PERCY PETERSON (PRESIDENT) |
| Authorized Official Telephone | 8057964595 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | C50553 | CA | Hospitals |
| Street Address |
16850 BEAR VALLEY RD |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-5794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104908 | Renaissance Radiology Medical Group, Inc. | Radiology | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2005-06-16 |
| 1780216853 | Hieu Trung Huynh | Pharmacist | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2020-02-06 |
| 1801428107 | Stephanie Victoria Ingrassia | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2020-02-05 |
| 1831737188 | Jannet Cardin | Pharmacist | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-12-18 |
| 1265070684 | Regina Renee Cendejas | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-12-16 |
| 1013568526 | Krystle Ann Frazier | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-09-25 |
| 1265088116 | Stephany Salazar | Clinic/Center | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-08-16 |
| 1346893054 | Junel Buenafe Tagayuna | Pharmacist | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-07-22 |
| 1942865381 | Duvan Martinez | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-05-01 |
| 1568925378 | Nicole Marie Sweeney | Speech-Language Pathologist | 16850 Bear Valley Rd, Victorville, CA 92395-5795 | 2019-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366850091 | Victor Valley Hospital Acquisition Inc | General Acute Care Hospital | 12384 Palmdale Rd, Suite 104, Victorville, CA 92392-8506 | 2014-07-25 |
| 1457776833 | Anesthesia Iag Services Ltd | General Acute Care Hospital | 13332 Cabana Way, Victorville, CA 92392-6364 | 2014-02-21 |
| 1679879589 | Victor Valley Hospital Acquisition, Inc. | General Acute Care Hospital | 15248 11th St, Victorville, CA 92395-3704 | 2011-02-10 |
| 1639487465 | Phsf Victor Valley, LLC | General Acute Care Hospital | 15248 Eleventh St, Victorville, CA 92395-3704 | 2010-09-14 |
| 1396959516 | Victor Valley Community Hospital | General Acute Care Hospital | 15248 11th St, Victorville, CA 92395-3704 | 2007-05-09 |
| 1619191079 | Victor Valley Community Hospital | General Acute Care Hospital | 15248 11th St, Victorville, CA 92395-3704 | 2007-04-13 |
| 1952311953 | Victor Valley Community Hospital | General Acute Care Hospital | 15248 11th St, Victorville, CA 92395-3704 | 2006-08-09 |
| 1851396576 | Desert Valley Hospital, Inc. | General Acute Care Hospital | 16850 Bear Valley Rd, Attention Hospital Business Office, Victorville, CA 92395-5794 | 2005-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763224 | Mola Medical Practice Inc | General Acute Care Hospital | 6906 Treasure Trl, Los Angeles, CA 90068-1838 | 2020-08-31 |
| 1497376966 | Barton Ambulatory Clinics | General Acute Care Hospital | 2170 South Ave Ste B, South Lake Tahoe, CA 96150-7026 | 2020-05-06 |
| 1346723194 | Eisenhower Medical Center | General Acute Care Hospital | 1401 North Palm Canyon Drive, Suite #202, Palm Springs, CA 92262 | 2018-09-07 |
| 1699282285 | Kern County Hospital Authority | General Acute Care Hospital | 6001 Truxtun Ave Ste 210, Bakersfield, CA 93309-0662 | 2018-01-04 |
| 1598272577 | Eisenhower Medical Center | General Acute Care Hospital | 74020 Alessandro Drive, Suite B, Palm Desert, CA 92260 | 2017-12-29 |
| 1720597511 | Children's Recovery Center 1, LLC | General Acute Care Hospital | 3777 S Bascom Ave, Campbell, CA 95008-7320 | 2017-09-25 |
| 1336668284 | Kern County Hospital Authority | General Acute Care Hospital | 2920 F St Ste B1, Bakersfield, CA 93301-1829 | 2017-09-12 |
| 1821524315 | Azadeh Salek | General Acute Care Hospital | 308 Paseo De La Playa Apt 4, Redondo Beach, CA 90277-6251 | 2017-05-03 |
| 1790210359 | Va Hospital Mather | General Acute Care Hospital | 3131 Sparrow Dr, Sacramento, CA 95834-2639 | 2017-04-20 |
| 1881127041 | Chad William Downing | General Acute Care Hospital | 28003 Via Del Agua, Laguna Niguel, CA 92677-7359 | 2017-04-05 |
| Find all providers with the same taxonomy | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
Please comment or provide details below to improve the information on KENNETH PERCY PETERSON, MD, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.