Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stacy Petersen Medical Group, PC

Organization Ophthalmology Physician · NPI 1194677955

Stacy Petersen Medical Group, PC is an Ophthalmology Physician in Riverside, California. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4445 Magnolia Ave
Riverside, CA 92501
Phone: (949) 991-4172
Fax: (949) 288-0429
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X

Record details

NPI number1194677955
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stacy Difley — Secretary · (949) 991-4172
NPI enumeratedFebruary 12, 2026
Last updated in NPPESFebruary 12, 2026
Certification dateFebruary 10, 2026
Mailing address26791 Aliso Creek Rd # 1018, Aliso Viejo, CA 92656-2887

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