David A Petersen, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G130506 Issued in CA

Practice address

4910 Directors PL Ste 350
San Diego, CA 92121-3834

Phone

(844) 484-4267

Fax

(949) 381-5687

NPI assigned

Nov 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1132358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1750363149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 S FORT HARRISON AVE STE D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337562072",
            "telephone_number": "727-724-3985",
            "fax_number": "727-726-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 DIRECTORS PL STE 350",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213834",
            "telephone_number": "844-484-4267",
            "fax_number": "949-381-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-19",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME54499",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G130506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037919100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonye Peters
• Zoe Peters
• Logan Timothy Peterschmidt, HOSPITAL CORPSMAN
• Anna Petersen
• Brett Petersen, M.D.
• George Justin Petersen, DPT
• Henry Soron Petersen, L.C.S.W.
• Kate Petersen
• Kathryn Petersen, MA
• Kaylee Petersen, ARNP

• Orthopaedic Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.