location
search-icon
institution
Kenneth A Peterson
Eyewear Supplier in Pismo Beach, California
NPI 1235371782

Kenneth A Peterson is a Eyewear Supplier based in Pismo Beach, CA. Kenneth A Peterson practices in Pismo Beach, CA. The NPI Number for Kenneth A Peterson is 1235371782 and holds a License No. CA 9884T (California).

The current practice location address for Kenneth A Peterson is 911 Oak Park Blvd Ste 104, Pismo Beach, CA and can be reached out via phone at 805-473-9393.

Location: 911 Oak Park Blvd Ste 104, Pismo Beach, CA, 93449-3406
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235371782
Provider Name
Kenneth A Peterson
Credential
Provider Entity Type
Organization
Address
911 Oak Park Blvd Ste 104, Pismo Beach, CA, 93449-3406
Phone Number
805-473-9393
Fax Number
Provider Enumeration Date
03/30/2009
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
OP9884 01 CA MEDICARE ID
SD0098840 05 CA
institution
Provider Business Practice Location Address Details
Address
911 Oak Park Blvd Ste 104
City
Pismo Beach
State
California
Zip
93449-3406
Phone Number
805-473-9393
Fax Number
person
Provider Business Mailing Address Details
Address
911 Oak Park Blvd Ste 104
City
Pismo Beach
State
California
Zip
93449-3406
Phone Number
805-473-9393
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Eyewear Supplier
Speciality
-
Taxonomy
332H00000X
License No.
CA 9884T (California)
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.