Eugene J. Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT29622 Issued in CA

Practice address

21501 Brookhurst St
Ste. E.
Huntington Beach, CA 92646-8080

Phone

(714) 963-7712

Fax

(714) 965-0682

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508838962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21501 BROOKHURST ST",
            "address_2": "STE. E.",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926468080",
            "telephone_number": "714-963-7712",
            "fax_number": "714-965-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21501 BROOKHURST ST",
            "address_2": "STE. E.",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926468080",
            "telephone_number": "714-963-7712",
            "fax_number": "714-965-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EUGENE",
        "middle_name": "J.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter a. Russo, DDS, Inc.
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• Peters Chiropractic
• Peters Chiropractic Corporation
• Steven Matthew Peters, D.C.
• Hunter Haylee Peterson
• Kelly Rose Peterson, DPT
• Kelsey Carl Peterson Jr., M.D.
• Laura Hayden Peterson
• Monique Peterson, P.T.

• Physical Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.