| Samuel R Peterson, MD | |
|
360 San Miguel Dr Ste 309, Newport Beach, CA 92660-7829 | |
| (949) 640-0434 | |
| Not Available |
| Full Name | Samuel R Peterson |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 360 San Miguel Dr Ste 309, Newport Beach, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073571295 | NPI | - | NPPES |
| 107017630101 | Other | UT | IHC HEALTHPLANS |
| QM0000066345 | Other | UT | ALTIUS |
| P00066498 | Other | UT | PALMETTO GBA |
| 03.00174 | Other | UT | UNITED HEALTHCARE |
| 72756 | Other | UT | PEHP |
| 796725 | Other | UT | DMBA |
| 870281028000 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 52631431205 (Utah) | Secondary |
| 207N00000X | Dermatology | C148028 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel R Peterson, MD 600 Corporate Dr, Ste 100, Ladera Ranch, CA 92694-2107 Ph: (949) 388-8022 | Samuel R Peterson, MD 360 San Miguel Dr Ste 309, Newport Beach, CA 92660-7829 Ph: (949) 640-0434 |
Annette Mcauley, RN Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1401 Avocado Ave, Ste 703, Newport Beach, CA 92660 Phone: 949-760-0190 Fax: 949-760-0439 |
Dr. Lisa Yun Xu, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 5010 Campus Dr Ste 120, Newport Beach, CA 92660 Phone: 949-773-4784 |
Laila M. Elkeeb, MD Dermatology Medicare: Medicare Enrolled Practice Location: 20301 Sw Birch St, 100, Newport Beach, CA 92660 Phone: 949-251-1502 Fax: 949-251-1522 |
Dr. Cynthia Chen Lazzaro, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1617 Westcliff Dr, Suite 100, Newport Beach, CA 92660 Phone: 949-515-4111 |
Nancy Lee Silverberg, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1401 Avocado Ave, Ste 703, Newport Beach, CA 92660 Phone: 949-760-0190 Fax: 949-760-0439 |
Dr. Leela Athalye, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 360 San Miguel Dr Ste 501, Newport Beach, CA 92660 Phone: 949-720-1170 |
Mrs. Kathleen P Hutton, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1441 Avocado Ave, Suite 309, Newport Beach, CA 92660 Phone: 949-644-8556 Fax: 949-644-6318 |