GABRIEL R PETTERSEN (NPI# 1740251727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740251727 |
| Entity Type | Individual |
| Full Name | GABRIEL R PETTERSEN |
| Credential | MD |
| Practice Address |
815 Court St Suite 7 Jackson CA 95642-2154 |
| Mailing Address |
10470 Old Placerville Rd Suite 100 Sacramento CA 95827-2539 |
| Practice Telephone | 2092575900 |
| Practice Fax Number | 2092575901 |
| Mailing Telephone | 8004700071 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | A89460 | CA | Other Service Providers |
| Y | 207R00000X | Internal Medicine | A89460 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
815 COURT ST SUITE 7 |
| City | JACKSON |
| State | CA |
| Zip Code | 95642-2154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487635546 | Gholamreza Firouz Pourzia | Internal Medicine | 815 Court St, Suite 5, Jackson, CA 95642-2154 | 2005-11-07 |
| 1134525322 | Susan Wright | Occupational Therapist | 815 Court St, Jackson, CA 95642-2154 | 2014-11-14 |
| 1548537871 | Puneet Kaur | Internal Medicine | 815 Court St, Suite 7, Jackson, CA 95642-2154 | 2011-12-01 |
| 1992716088 | Gary J Woodward | Internal Medicine | 815 Court St, Ste 7, Jackson, CA 95642-2154 | 2006-08-11 |
| 1801807995 | Stefan H Zineski | Internal Medicine | 815 Court St, Ste 7, Jackson, CA 95642-2154 | 2006-08-11 |
| 1528079621 | Dennis A Nousaine | Internal Medicine | 815 Court St, Ste 7, Jackson, CA 95642-2154 | 2006-08-11 |
| 1437160538 | Darrel Keith Kerr | Internal Medicine | 815 Court St, Ste 7, Jackson, CA 95642-2154 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| Find all providers in zip 95642 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1215556048 | Hannah Roberts Badon | Internal Medicine | 2450 Wild Valley Dr, Jackson, MS 39211-6224 | 2020-04-12 |
| 1649809476 | Rachel Horn Mullins | Internal Medicine | 5379 Fairway St, Jackson, MS 39211-4251 | 2020-04-03 |
| 1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
| 1356605752 | Jeremy Taylor | Internal Medicine | 971 Lakeland Dr Ste 450, Jackson, MS 39216-4615 | 2012-06-29 |
| 1134416019 | Zubair Khan | Internal Medicine | 3291 Creekwood Cir, Jackson, WI 53037-8927 | 2011-06-29 |
| 1801181466 | Anne Marie Shute | Internal Medicine | 7 Windwood Dr, Jackson, TN 38305-8835 | 2011-06-12 |
| 1487945648 | Howard Carroll Friday | Internal Medicine | 4019 Old Canton Rd., Jackson, MS 39216 | 2011-04-22 |
| 1801195003 | Mahir H Alsalman | Internal Medicine | 3100 Cooper St, Jackson, MI 49201-7545 | 2011-03-28 |
| 1912138967 | Tatum Medical Clinic | Internal Medicine | 5903 Ridgewood Rd Ste 330, Jackson, MS 39211-3702 | 2009-08-06 |
| 1306089040 | Hussein Othman | Internal Medicine | 205 Page Ave Ste B, Jackson, MI 49201-2462 | 2009-04-10 |
| Find all providers in JACKSON | ||||
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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.