Provider Demographics
NPI:1598811358
Name:PETERSON, KIRK L (MD)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:L
Last Name:PETERSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9350 CAMPUS POINT DRIVE
Mailing Address - Street 2:MC 8411
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:619-543-5666
Mailing Address - Fax:619-543-3774
Practice Address - Street 1:9350 CAMPUS POINT DRIVE
Practice Address - Street 2:MC 8411
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-8411
Practice Address - Country:US
Practice Address - Phone:619-543-5666
Practice Address - Fax:619-543-3774
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG16298207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease