DR. SANDRA ROSE PETERSEN (NPI# 1295795672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295795672 |
| Entity Type | Individual |
| Full Name | DR. SANDRA ROSE PETERSEN |
| Credential | M.D. |
| Practice Address |
4060 4th Ave Suite 610 San Diego CA 92103-2116 |
| Practice Telephone | 6194972430 |
| Practice Fax Number | 6192991723 |
| Mailing Telephone | 6194972430 |
| Mailing Fax Number | 6192991723 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | G051961 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215162995 | Sandra Lee Petersen | Speech-Language Pathologist | 805 W Stonemill Ave, Addison, IL 60101-2210 | 2009-05-24 |
| 1821070368 | Sandra E Petersen | Marriage & Family Therapist | 43613 Florida Ave, Suite K, Hemet, CA 92544-7202 | 2005-11-18 |
| 1285171801 | Sandra Mary Bednarz Petersen | Counselor | 1900 Ogden Ave, Aurora, IL 60504-4273 | 2017-01-20 |
| 1568916260 | Sandra Petersen | Marriage & Family Therapist | 25 N 100 E Ste 102, St George, UT 84770-7369 | 2016-08-10 |
| 1407074024 | Sandra M. Petersen | Pharmacist | 13400 E Shea Blvd, Scottsdale, AZ 85259-5404 | 2007-04-20 |
| 1548396849 | Sandra Petersen | Nurse Practitioner | 6800 West Loop S, Suite 180, Bellaire, TX 77401-4528 | 2007-02-23 |
| Street Address |
4060 4TH AVE SUITE 610 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525299 | John Paul Molenaar | Audiologist | 4060 4th Ave, Ste 410a, San Diego, CA 92103-2121 | 2005-06-01 |
| 1598391740 | Sheena Lee Hays | Registered Nurse | 4060 4th Ave, San Diego, CA 92103-2116 | 2020-03-19 |
| 1336645324 | Kiyon Chung Md, Apc | Internal Medicine | 4060 4th Ave, Suite 650, San Diego, CA 92103-2121 | 2018-03-30 |
| 1003260894 | Erin Dwyer | Nurse Practitioner | 4060 4th Ave, Suite 310, San Diego, CA 92103-2116 | 2016-04-18 |
| 1336515642 | Leslie Monagle | Physical Therapist | 4060 4th Ave, Suite 206, San Diego, CA 92103-2116 | 2015-08-20 |
| 1598008583 | Stewart L. Frank Md, Inc. | Non-Pharmacy Dispensing Site | 4060 4th Ave, Suite 605, San Diego, CA 92103-2116 | 2013-03-28 |
| 1912269945 | Kennie Kwok | Dentist | 4060 4th Ave, Suite 303, San Diego, CA 92103-2116 | 2012-06-14 |
| 1124391974 | Central San Diego Surgery Center Inc. | Clinic/Center | 4060 4th Ave, Suite #120, San Diego, CA 92103-2116 | 2012-02-09 |
| 1366734220 | Joey Allen Clayton | Physician Assistant | 4060 4th Ave, Suite 700, San Diego, CA 92103-2116 | 2011-05-11 |
| 1578869772 | Jason R Hess Plastic Surgery Inc | Surgery | 4060 4th Ave, Suite 120, San Diego, CA 92103-2116 | 2011-02-04 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316494768 | Samantha Berg | Obstetrics & Gynecology | 9339 Genesee Ave Ste 220, San Diego, CA 92121-2121 | 2016-09-01 |
| 1326495276 | Elizabeth Anne Coulter | Obstetrics & Gynecology | 200 West Arbor Drive, Mc8433, Ucsd Residency Office, San Diego, CA 92103 | 2016-05-20 |
| 1962889121 | Reproductive Sciences Medical Center | Obstetrics & Gynecology | 3661 Valley Centre Dr, Suite 100, San Diego, CA 92130-3321 | 2015-04-27 |
| 1134515695 | Tiffani Phan | Obstetrics & Gynecology | 550 Washington St Ste 331, San Diego, CA 92103-2227 | 2015-04-11 |
| 1437544251 | Lindsey Ann Burnett | Obstetrics & Gynecology | 200 West Arbor Drive, Mailcode 8433, University of California San Diego, San Diego, CA 92103 | 2015-03-30 |
| 1811240906 | Charles Hamrang | Obstetrics & Gynecology | 3250 Bunker Hill, San Diego, CA 92117 | 2012-10-26 |
| 1780955328 | Gerald M Spector | Obstetrics & Gynecology | 4045 Couts St, San Diego, CA 92103-1501 | 2012-01-12 |
| 1841578572 | L Dale Lapp M D Inc | Obstetrics & Gynecology | 4060 4th Ave Ste 640, San Diego, CA 92103-2118 | 2011-07-29 |
| 1114221603 | Leroy Albert Miller | Obstetrics & Gynecology | 2359 Juan Street, San Diego, CA 92103 | 2010-12-27 |
| 1154635415 | Robert J Santella, Md. Inc. | Obstetrics & Gynecology | 4531 College Ave, San Diego, CA 92115-4010 | 2010-07-28 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on DR. SANDRA ROSE PETERSEN.
| 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.