George Justin Petersen
Physical Therapist - Geriatrics
3064 Fried Ave
San Diego
, California 92122-2235
George Justin Petersen
Physical Therapist - Geriatrics
3064 Fried Ave
San Diego
, California 92122-2235
(858) 405-2855
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About
Features
Specialties
- Physical Therapist - Geriatrics
Languages spoken
- English
Location
First Address
- George Justin Petersen
- 3064 Fried Ave
- San Diego, CA
- Zip : 92122-2235
- Phone : (858) 405-2855
Second Address
- George Justin Petersen
- 3064 Fried Ave
- San Diego, CA
- Zip : 92122-2235
- Phone : (858) 405-2855
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251G0304X | Physical Therapist - Geriatrics | 36323 | CA |
National Provider Identifier
| NPI | 1144767468 |
|---|---|
| Provider Name | George Justin Petersen |
| First Address | San Diego, CA 92122-2235 |
| Second Address | San Diego, CA 92122-2235 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/01/2017 |
| Last Update Date | 24/01/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.