DR. CHARLES CAPDEVILLE PETERSON (NPI# 1871036798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871036798 |
| Entity Type | Individual |
| Full Name | DR. CHARLES CAPDEVILLE PETERSON |
| Credential | D.O. |
| Practice Address |
801 S Chevy Chase Dr Ste 230 Glendale CA 91205-4436 |
| Mailing Address |
1125 E Broadway # 71 Glendale CA 91205-1315 |
| Practice Telephone | 8185005586 |
| Practice Fax Number | 8185005587 |
| Mailing Telephone | 8185005586 |
| Mailing Fax Number | 8185005587 |
| Enumeration Date | 2016-11-25 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20A15085 | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 20A15085 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609026897 | Charles Marquis Peterson | Internal Medicine | 12910 Dalyn Dr, Potomac, MD 20854-1176 | 2008-09-24 |
| 1134243355 | Charles Mark Peterson | Registered Nurse | 830 14th Ave, Seattle, WA 98122-4508 | 2007-03-16 |
| 1902973415 | Charles Walter Peterson | Optometrist | 904 Elliott Ave N, Wenatchee, WA 98801-1666 | 2006-11-29 |
| 1558472613 | Charles Edwin Peterson | Internal Medicine | 904 Meadow Lane, Schenectady, NY 12309 | 2006-08-31 |
| 1700845526 | Charles A Peterson | Orthopaedic Surgery | 8438 N Mercer Way, Mercer Island, WA 98040-3134 | 2006-03-21 |
| 1952302143 | Charles Smith Peterson | Family Medicine | 3130 E Baseline Rd, Suite 101, Mesa, AZ 85204-7290 | 2005-08-10 |
| 1154798502 | Charles Peterson | Counselor | 185 Silas Deane Hwy, Wethersfield, CT 06109 | 2015-09-01 |
| 1982018818 | Charles William Peterson Iv | Behavioral Analyst | 21929 Highland Knolls Dr, Katy, TX 77450-5873 | 2014-06-18 |
| 1295026821 | Charles John Peterson | Student in an Organized Health Care Education/Training Program | 308 Harvard St Se, Minneapolis, MN 55455-0343 | 2011-05-01 |
| 1437234499 | Charles John Peterson | Emergency Medicine | 5301 E Grant Road, Tucson Medical Center Emergency Department, Tucson, AZ 85712-2805 | 2006-10-26 |
| Street Address |
801 S CHEVY CHASE DR STE 230 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91205-4436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639138001 | Rene E Pidoux | Family Medicine | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2006-03-22 |
| 1356905954 | Daisha Ortega | Student in an Organized Health Care Education/Training Program | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2019-04-29 |
| 1235793282 | Natalie Anne Boone | Student in an Organized Health Care Education/Training Program | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2019-04-25 |
| 1629632997 | Maria Teresa Sanchez | Student in an Organized Health Care Education/Training Program | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2019-04-23 |
| 1003386558 | Nare Stepanyan | Family Medicine | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2018-11-27 |
| 1619499050 | Tala Stephanie Ghadimi I | Student in an Organized Health Care Education/Training Program | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2017-07-07 |
| 1871027540 | Raffi Petrosian | Student in an Organized Health Care Education/Training Program | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2017-04-19 |
| 1043752751 | Alexander Hu | Family Medicine | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2016-11-11 |
| 1821457250 | Alison Kole | Family Medicine | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2016-02-12 |
| 1003287517 | Allandale Yap | Family Medicine | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2015-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104466382 | Ashley Torres | Behavior Technician | 501 East Harvard Street, Glendale, CA 91205 | 2020-01-15 |
| 1306492277 | Maria Veronica A Lopez | Registered Nurse | 1000 E Windsor Rd, Unit 2, Glendale, CA 91205 | 2019-08-15 |
| 1801373469 | Lucky Riders Inc. | Non-emergency Medical Transport (VAN) | 1251 Boynton St Apt 1, Glendale, CA 91205 | 2018-07-25 |
| 1669967006 | Happy Life Home Health Care Inc | Home Health | 225 East Broadway St, Suite 203, Glendale, CA 91205 | 2018-06-28 |
| 1841782356 | Liana Hariri | Case Manager/Care Coordinator | 1540 E. Colorodo St., Glendale, CA 91205 | 2018-05-31 |
| 1992202469 | Narek Garukyan Dpm | Clinic/Center | 815 E Colorado St Ste 210, Glendale, CA 91205 | 2018-04-10 |
| 1619496080 | Elite Care Home Health Services Inc | Home Health | 225 E.broadway, Suite B114, Glendale, CA 91205 | 2017-09-16 |
| 1396284980 | Ingrid Pamela Vazquez Solis | Case Manager/Care Coordinator | 1540 E. Colorado Street, Glendale, CA 91205 | 2017-02-16 |
| 1730533670 | Arm Trans Management Company | Non-emergency Medical Transport (VAN) | 627 E. Windsor Rd # 6, Glendale, CA 91205 | 2016-04-18 |
| 1104290824 | Caremore Health Plan | Nurse Practitioner | 406 E. Colorado Street, Glendale, CA 91205 | 2015-11-18 |
| Find all providers in zip 91205 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356967327 | Kristian Adair | Family Medicine | 7200 W Bell Rd Ste E102, Glendale, AZ 85308-8534 | 2020-06-24 |
| 1336761295 | Glendale Whole Health | Family Medicine | 230 N Maryland Aave #110, Glendale, CA 91206 | 2020-05-14 |
| 1053930248 | Shine Mmg Inc | Family Medicine | 450 N Brand Blvd Ste 625a, Glendale, CA 91203-2347 | 2020-04-08 |
| 1497381446 | Leonardo C Ortiz Md A Medical Corporation | Family Medicine | 2145 Ashington Dr, Glendale, CA 91206-1140 | 2020-03-20 |
| 1508498130 | Nare Stepanyan Md Inc | Family Medicine | 1030 S Glendale Ave Ste 503, Glendale, CA 91205-2820 | 2020-02-11 |
| 1194368530 | Carolyn Kathan | Family Medicine | 3732 W Charleston Ave, Glendale, AZ 85308-2708 | 2019-10-17 |
| 1932740966 | Starcare Homes LLC | Family Medicine | 9416 W Colter St, Glendale, AZ 85305-3373 | 2019-10-01 |
| 1871050559 | Mensa Family Clinic Inc | Family Medicine | 1110 S Glendale Ave Ste E, Glendale, CA 91205-5623 | 2019-02-28 |
| 1891279907 | Denise M Gomez | Family Medicine | 7200 W Bell Rd Unit 101, Glendale, AZ 85308-8529 | 2018-09-24 |
| 1427537299 | Brilliant Health Center Inc | Family Medicine | 1014 E Colorado St, Glendale, CA 91205-1226 | 2018-08-12 |
| Find all providers in GLENDALE | ||||
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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.