T K Peterson MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

A26295 Issued in CA

Legal business name

T K PETERSON MD

Practice address

3617 MLK Boulevard Suite 1
Lynwood, CA 90262

Phone

(310) 638-5119

Fax

(310) 635-0738

NPI assigned

Apr 6, 2012

Last updated

Apr 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Kimball Peterson, MD

Title

President

Phone

(310) 638-5119

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333670400000",
    "number": "1548526320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 MLK BLVD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "90262",
            "telephone_number": "310-638-5119",
            "fax_number": "310-635-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 MLK BOULEVARD SUITE 1",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "90262",
            "telephone_number": "310-638-5119",
            "fax_number": "310-635-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T K PETERSON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "KIMBALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-638-5119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A26295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medardo C. Supnet, M.D.
• Prashanth Sutrave, MD
• Sylvia J Shaw MD a Medical Corp
• Albert K Szeto, MD
• Ashley Szmania, NP
• May Aya Tajima
• Chong H Tak, MD
• Terence TZ Tan, M.D.
• Elizabeth Tang
• Katarina Mina Tasic, M.D.

• Specialist in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.