DR. SCOTT J. PETERSEN (NPI# 1710034251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710034251 |
| Entity Type | Individual |
| Full Name | DR. SCOTT J. PETERSEN |
| Credential | MD |
| Practice Address |
275 W Macarthur Oakland CA 94611-5641 |
| Practice Telephone | 5107521000 |
| Practice Fax Number | 5106209222 |
| Mailing Telephone | 5107521000 |
| Mailing Fax Number | 5106209222 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2014-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | G066975 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689640948 | Scott D. Petersen | Physician Assistant | 33300 Cleveland Clinic Blvd, Mail Code Avh4-143, Avon, OH 44011 | 2006-02-27 |
| 1922420082 | Scott Petersen | Counselor | 625 N Plaza Dr, Apache Junction, AZ 85120-5501 | 2014-01-09 |
| 1346561966 | Scott Petersen | Counselor | 757 S Main St, Springville, UT 84663-2452 | 2010-06-17 |
| 1295931046 | Scott William Petersen | Dentist | 310 N 400 E, Nephi, UT 84648-1558 | 2007-06-26 |
| 1386758183 | Scott R Petersen | Social Worker | 2111 Champa St, Denver, CO 80205-2529 | 2006-08-18 |
| 1275574519 | Scott Martin Petersen | Obstetrics & Gynecology | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2006-06-09 |
| 1912986555 | Scott Richard Petersen | Surgery | 500 W Thomas Rd, Suite 400, Phoenix, AZ 85013-4224 | 2006-01-12 |
| Street Address |
275 W MACARTHUR |
| City | OAKLAND |
| State | CA |
| Zip Code | 94611-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132580 | David Law | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2005-05-31 |
| 1003247818 | Suzanne P Whitcomb | Physical Therapist | 275 W Macarthur, Oakland, CA 94611-5641 | 2013-12-03 |
| 1629400445 | Jason Villarin | Physical Therapist | 275 W Macarthur, Oakland, CA 94611-5641 | 2013-08-02 |
| 1619311560 | Failin Au | Psychologist | 275 W Macarthur, Oakland, CA 94611-5641 | 2013-04-22 |
| 1447592266 | Kimberly Gail Ernest | Physician Assistant | 275 W Macarthur, Oakland, CA 94611-5641 | 2013-03-19 |
| 1336489657 | Heather L. Tyson | Physical Therapist | 275 W Macarthur, Oakland, CA 94611-5641 | 2013-02-22 |
| 1083966931 | Gregory Miller Barnell | Nurse Practitioner | 275 W Macarthur, Oakland, CA 94611-5641 | 2012-10-02 |
| 1164773594 | Bonnie L Taylor | Physician Assistant | 275 W Macarthur, Oakland, CA 94611-5641 | 2012-09-25 |
| 1073861308 | Heidi Evelynne Meck | Psychologist | 275 W Macarthur, Oakland, CA 94611-5641 | 2012-08-16 |
| 1457607913 | Shilpa V Patel | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2012-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063028454 | Abduljabbar Alhammoud | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Oakland Medical Center 275 W. Macarth, Oakland, CA 94611 | 2020-09-21 |
| 1184287435 | Unfold Psychology: A. Heafey Practice | Psychologist | 1955 Mountain Blvd., Suite 101, Oakland, CA 94611 | 2019-04-22 |
| 1700389699 | Katie Herron | Student in an Organized Health Care Education/Training Program | 2535 Harrison St., Oakland, CA 94611 | 2018-03-16 |
| 1861923351 | Hoiwan Cheung | Student in an Organized Health Care Education/Training Program | 3600 Broadway, 4th Fl., Suite 43, Kaiser Oakland, Oakland, CA 94611 | 2017-03-25 |
| 1104377126 | Collin Chan | Pharmacist | 3801 Howe Street, Fabiola G-25, Oakland, CA 94611 | 2016-10-14 |
| 1912457276 | Madeline Marie Perket | Registered Nurse | 933 Kingston Ave, Piedmont, CA 94611 | 2016-10-11 |
| 1962959460 | Healing Arts Chiropractic | Chiropractor | 187 40th Street Way, Oakland, CA 94611 | 2016-09-01 |
| 1033573829 | Diana Murphy | Counselor | 629 Oakland, Oakland, CA 94611 | 2016-04-08 |
| 1437515483 | Laura Northrup II | Marriage & Family Therapist | 3873 Piedmont Ave, Suite 5, Oakland, CA 94611 | 2016-01-06 |
| 1558736835 | Michael Joseph Scollard | Dentist | 42 Linda Ave., Oakland, CA 94611 | 2015-12-11 |
| Find all providers in zip 94611 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588121537 | Recode Health | General Practice | 1850 Mountain Blvd, Oakland, CA 94611-2265 | 2019-02-26 |
| 1033661962 | Michael Mustille | General Practice | 6201 Swainland Rd, Oakland, CA 94611-1841 | 2016-10-26 |
| 1659753614 | Wanda Heffernon | General Practice | 2360 Scout Rd, Oakland, CA 94611-2724 | 2015-06-25 |
| 1457798159 | Gregory Allen Niederhauser | General Practice | 1541 W Buell Rd, Oakland, MI 48363-2331 | 2013-06-04 |
| 1720334279 | Luyen V. Ta, M.d., Inc/tuong-vi Ta, M.d. | General Practice | 341 9th Street, Suite A, Oakland, CA 94607 | 2012-08-01 |
| 1629334032 | Kristian Shinyu Gima | General Practice | 1438 3rd St Unit B, Oakland, CA 94607-1806 | 2012-04-10 |
| 1396019303 | Owen Shibata | General Practice | 2100 Embarcadero, Oakland, CA 94606-5302 | 2012-03-08 |
| 1548415979 | John Karl Konstantin | General Practice | 2584 Macarthur Blvd, Oakland, CA 94602-2928 | 2008-11-26 |
| 1790909588 | Edward Sanders | General Practice | 3706 Telegraph Ave, Oakland, CA 94609-2418 | 2007-04-12 |
| 1700943412 | Anh Trung Do | General Practice | 919 Harrison Street, Suite A, Oakland, CA 94607-4494 | 2007-01-02 |
| Find all providers in OAKLAND | ||||
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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.