NPI 1073571295

Samuel R Peterson, MD

Practitioner Dermatology Physician Newport Beach, CA

Practice location

Address: 360 San Miguel Dr STE 309, Newport Beach, CA 92660-7829
Phone: (949) 640-0434
Mailing address: 600 Corporate Dr STE 100, Ladera Ranch, CA 92694-2107

Registered specialties (2)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence C148028 (CA)

Other Dermatology providers in California →

Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 52631431205 (UT)

Registry record

NPI: 1073571295
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 May 2006
Record last updated: 19 Jan 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.