PROF. JEFFREY PETERSEN (NPI# 1649312752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649312752 |
| Entity Type | Individual |
| Full Name | PROF. JEFFREY PETERSEN |
| Credential | M.D. |
| Practice Address |
300 Pasteur Dr # A175mc5309 Stanford CA 94305-2200 |
| Practice Telephone | 6507231151 |
| Practice Fax Number | 6507237917 |
| Mailing Telephone | 6507231151 |
| Mailing Fax Number | 6507237917 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
A36290 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A362900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669454211 | Jeffrey Ian Petersen | Dentist | 2448 Guerneville Rd, Santa Rosa, CA 95403-4175 | 2005-11-18 |
| 1912367251 | Jeffrey Petersen | Physical Therapist | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2016-02-29 |
| 1912330085 | Jeffrey Daniel Petersen | Counselor | 2655 Enterprise Rd, Reno, NV 89512-1666 | 2013-08-13 |
| 1184998585 | Jeffrey Ming Petersen | Pathology | 10833 Le Conte Ave, 13-145a Center for Hlth Sci, Los Angeles, CA 90095-3075 | 2012-03-02 |
| 1952543969 | Jeffrey W. Petersen | Specialist/Technologist | 308 S 3rd St, Watseka, IL 60970-1604 | 2009-04-06 |
| 1891977419 | Jeffrey Scott Petersen | Counselor | 500 Crown Point Cir, Grass Valley, CA 95945-9514 | 2007-12-05 |
| 1841389699 | Jeffrey Petersen | Physical Therapist | 1844 E Baseline Rd Ste C5, Tempe, AZ 85283-1506 | 2006-10-12 |
| 1699794735 | Jeffrey Petersen | Family Medicine | 1035 S Main Ave, Fallbrook, CA 92028-3338 | 2006-07-19 |
| 1275551707 | Jeffrey E Petersen | Dermatology | 1011 Bowles Ave, Suite 121, Fenton, MO 63026-2395 | 2006-07-17 |
| Street Address |
300 PASTEUR DR # A175MC5309 |
| City | STANFORD |
| State | CA |
| Zip Code | 94305-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092126 | Meilin Liang | Physician Assistant | 300 Pasteur Rd, Rm H0101, Stanford, CA 94305 | 2020-07-31 |
| 1356962484 | Shuo Cai | Student in an Organized Health Care Education/Training Program | 300 Pasteur Drive Stanford University School of Medici, Lane Building, Stanford, CA 94305 | 2020-04-29 |
| 1760046916 | Jennifer M Piselli | Physician Assistant | 300 Pasteur Drive Rm A345, 3rd Floor, Stanford, CA 94305 | 2019-04-23 |
| 1912482365 | Martin Nikolaus Stienen | Neurological Surgery | Department of Neurosurgery,stanford University Hospital, 300 Pasteur Drive, Edwards Bldg., Rm R209, Stanford, CA 94305 | 2018-10-02 |
| 1043797434 | Natalie Lynn Dykzeul | Genetic Counselor, MS | 300 Pasteur Drive H315, Stanford, CA 94305 | 2018-07-27 |
| 1144727223 | Kingsley Anuoluwapo Oladeji | Student in an Organized Health Care Education/Training Program | Stanford Health Care Dept. of Gme, 300 Pasteur Drive, Palo Alto, CA 94305 | 2018-04-06 |
| 1437675402 | Abhinav Sharma | Internal Medicine | 300 Pasteur Lane, Falk Building, Palo Alto, CA 94305 | 2017-08-21 |
| 1194258491 | Silvia Paola Russo | Student in an Organized Health Care Education/Training Program | 300 Pasteur Dr # H3144, Palo Alto, CA 94305 | 2017-04-04 |
| 1649629155 | Jason Ross | Student in an Organized Health Care Education/Training Program | Stanford University School of Medicine Stanford Cancer, 875 Blake Wilbur Drive, Stanford, CA 94305 | 2016-06-06 |
| 1588010235 | Brian Dang | Pharmacist | 500 Pasteur Drive Room J010, Stanford, CA 94305 | 2016-05-12 |
| Find all providers in zip 94305 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922141951 | Richard Alan Lafayette | Internal Medicine | Stanford Hospital Clinics 300 Pasteur Drive, Stanford, CA 94305 | 2007-02-15 |
| 1518386911 | Shen Song | Internal Medicine | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2014-04-14 |
| 1992122238 | Daniel Joseph Watford | Internal Medicine | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2014-03-25 |
| 1073844510 | Jay Prakash Garg | Internal Medicine | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2010-01-22 |
| 1356486674 | Bryan D Myers | Internal Medicine | 300 Pasteur Drive, S161 Grant Building, Stanford, CA 94305 | 2007-02-21 |
| 1356428072 | Robert Tristian Isom | Internal Medicine | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2006-11-01 |
| 1033201710 | Vasyl Warvariv | Internal Medicine | 300 Pasteur Dr, A160 Mc 5309, Stanford, CA 94305-2200 | 2006-09-29 |
| 1306896758 | Stanford Hospital and Clincs | Internal Medicine | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2006-05-10 |
| 1407823875 | Glenn Matthew Chertow | Internal Medicine | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2006-03-03 |
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|---|---|---|---|---|
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| 1538774989 | Modern Telehealth | Internal Medicine | 1509 Espinosa Cir, Palos Verdes Estates, CA 90274-1917 | 2020-09-12 |
| 1073137733 | Jafar Alsaid | Internal Medicine | 2009 Baywood Ln, Davis, CA 95618-0500 | 2020-05-29 |
| 1164041422 | Advanced Care Multispecialty Medical Group Apc | Internal Medicine | 13990 Bear Fence Court, Moorpark, CA 93021-5022 | 2020-04-15 |
| 1629600416 | Valley Kidney Medical Group Inc | Internal Medicine | 1646 E Herndon Ave Ste 106, Fresno, CA 93720-3380 | 2020-02-10 |
| 1437789278 | Spectrum Dialysis | Internal Medicine | 18040 Sherman Way Ste 220, Reseda, CA 91335-4631 | 2020-01-21 |
| 1932745007 | K Care Ipa | Internal Medicine | 18000 Studebaker Rd Ste 100, Cerritos, CA 90703-7929 | 2019-11-22 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1669930723 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 160, Chico, CA 95928-8351 | 2019-03-07 |
| 1295293363 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 220, Chico, CA 95928-8351 | 2019-03-07 |
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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.