Diane Yvonne Petersen, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G54758 Issued in CA

Practice address

3565 Del Amo Blvd
3Rd Floor
Torrance, CA 90503-1637

Phone

(310) 214-0811

Fax

(310) 793-0754

NPI assigned

Jun 30, 2006

Sex

Female

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1992734420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 DEL AMO BLVD",
            "address_2": "3RD FLOOR",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031637",
            "telephone_number": "310-214-0811",
            "fax_number": "310-793-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 DEL AMO BLVD",
            "address_2": "3RD FLOOR",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031637",
            "telephone_number": "310-214-0811",
            "fax_number": "310-793-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DIANE",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G54758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter S Borden a Med Corp
• Peter S Borden MD
• Peter S. Borden, M.D., a Medical Corporation
• Peter S. Lorman, M.D., a Professonal Corp
• Brittany Peters
• Ethan Merrill Petersen
• Greg Edward Petersen, P.T.
• Patricia Mothner Petersen, LMFT
• Candace J Peterson-Kahn, MFT
• Lisa Rivo Peterson, PH.D.

• Otolaryngology Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.