Thomas Peterson, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A26295 Issued in CA

Practice address

3628 E Imperial Hwy
Suite #300
Lynwood, CA 90262-2609

Phone

(310) 900-8490

Fax

(310) 635-0738

NPI assigned

Nov 30, 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

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1972671972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD",
            "address_2": "SUITE 203",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165109",
            "telephone_number": "818-986-0200",
            "fax_number": "818-638-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "SUITE #300",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8490",
            "fax_number": "310-635-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A26295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A262950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• De'Mawn Zino Perkins
• Angela Perry, AMFT
• Eric Perry
• Kati Lee Persons
• Joseph Carter Peters, M.D.
• Kimetha Laurie Petteway-Turner, LMFT
• Susan Pham
• Pharmedquest Pharmacy Services
• Andrea C Phillips, REG INTERN # 63262
• Carrie Pickinpaugh

• 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 Oct 29, 2014; 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.