DR. MICHAEL R PETERSON (NPI# 1700087376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700087376 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL R PETERSON |
| Credential | M.D. |
| Practice Address |
200 West Arbor Dr Mc 8720 San Diego CA 92103-8720 |
| Practice Telephone | 6195435966 |
| Practice Fax Number | 6195433730 |
| Mailing Telephone | 6195435966 |
| Mailing Fax Number | 6195433730 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
A90731 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1548715634 | Michael Latrae Peterson | Social Worker | 6767 W Windmill Ln, Las Vegas, NV 89139-6501 | 2016-08-18 |
| 1033544119 | Michael Robert Peterson | Counselor | 522 4th St S, Stillwater, MN 55082-4966 | 2013-09-09 |
| 1750651113 | Michael Peterson | Social Worker | 1400 N Hayworth Ave Apt 9, West Hollywood, CA 90046-3836 | 2012-01-03 |
| 1578848131 | Michael Dean Peterson | Dentist | 4710 Amber Valley Pkwy S, Ste A, Fargo, ND 58104 | 2011-10-14 |
| 1467693119 | Michael Lamont Peterson | Registered Nurse | 13 Hollister St, Rochester, NY 14605-1401 | 2009-03-10 |
| 1003062001 | Michael Carl Peterson | Physical Therapist | 2850 Mitchell Rd, Jamestown, NY 14701-8906 | 2008-08-11 |
| 1942472691 | Michael E Peterson | Dentist | 5355 W State St, Boise, ID 83703-3333 | 2008-04-01 |
| 1134325145 | Michael W Peterson | Dentist | 1319 Tennessee St, Vallejo, CA 94590 | 2007-06-26 |
| 1609079094 | Michael Gene Peterson | Emergency Medicine | 201 E. Nicollet Blvd., Burnsville, MN 55337 | 2007-06-06 |
| Street Address |
200 WEST ARBOR DR MC 8720 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-8720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548222532 | Brandie Jo Ciceri | Nurse Practitioner | 200 West Arbor Dr, Uscd Medical Center - Dept. of Gi, San Diego, CA 92103 | 2006-04-05 |
| 1649799370 | Dmitri Lerner | Pharmacist | 200 West Arbor Dr, San Diego, CA 92103-7695 | 2017-09-13 |
| 1568726602 | Vincent Cheung | Student in an Organized Health Care Education/Training Program | 200 West Arbor Dr, Division of Neurosurgery, Mailcode 8893, San Diego, CA 92103 | 2012-07-03 |
| 1629385836 | Gert Diederick Victor Pretorius | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 West Arbor Dr, Mc 8892, San Diego, CA 92103-9001 | 2010-09-09 |
| 1275702797 | Frank J Papatheofanis | Nuclear Medicine | 200 West Arbor Dr, Ucsd Radop;pgu Mc 8758, San Diego, CA 92103-8758 | 2008-02-28 |
| 1275744252 | Merry Christine Blantz | Nurse Practitioner | 200 West Arbor Dr, San Diego, CA 92103-8409 | 2007-05-24 |
| 1699988667 | Julie Lynn Marek Bykowski | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 1356554323 | Sharon Brouha | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 1770796781 | Danielle B Nanigian | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 1669685673 | Arvin Hariri | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| 1548786163 | Uc San Diego | Pathology | 200 West Arbor Drive Mc 8320, San Diego, CA 92103 | 2017-08-15 |
| 1669818456 | Stephanie Erin Muller | Pathology | 9295 Farnham Street, Suite 100, San Diego, CA 92123 | 2013-05-20 |
| 1740571264 | Lynn A Lancaster | Pathology | 4633 E Talmadge Dr, San Diego, CA 92116-4829 | 2011-05-02 |
| 1255633442 | Lawrence Browning Willes | Pathology | 200 W Arbor Dr # Mc8720, San Diego, CA 92103-9001 | 2010-11-22 |
| 1063724920 | Veena Singh | Pathology | 9640 Towne Centre Dr Ste 200, San Diego, CA 92121-1963 | 2010-07-08 |
| 1194056820 | James Russell Nickel | Pathology | 3446 Hancock St, Suite C, San Diego, CA 92110-4306 | 2010-01-20 |
| 1386832640 | Aamir Ahsan | Pathology | 9295 Farnham St Ste 100, San Diego, CA 92123-1254 | 2007-10-11 |
| 1437340445 | Maria Lourdes Fernandez Reyes | Pathology | 6371 Rancho Mission Rd, Unit 2, San Diego, CA 92108-2016 | 2007-08-05 |
| 1316030984 | James J Underwood | Pathology | 9853 Pacific Heights Blvd, Ste B, San Diego, CA 92121-4721 | 2006-10-02 |
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| 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.