Anthony L Peterson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

35241 Issued in CA

Practice address

5220 Douglas Blvd
Granite Bay, CA 95746-6205

Phone

(707) 430-3740

NPI assigned

Aug 28, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1376377655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 SENEGAL WAY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626402",
            "telephone_number": "707-430-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 DOUGLAS BLVD",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466205",
            "telephone_number": "707-430-3740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13405 Folsom Blvd",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956304737",
            "country_code": "US",
            "telephone_number": "707-430-3740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANTHONY",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "35241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizibeth Patton
• Mario R Pena Carranza
• Nely Pena
• Bobbi Peters
• Carl David Petersen, MD
• Kenneth Pham, PHARM.D.
• Christine Pickett
• Placer County - Vista Creek
• Placer Psychiatry Group, Inc.
• Logan Potter

• Chiropractor in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.