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

Samuel R Peterson, MD

Individual provider Dermatology Physician · NPI 1073571295

Samuel R Peterson, MD is a Dermatology Physician in Newport Beach, California. Licensed in California and Utah. Registered with an NPI since 2006.

Licensed in
CA, UT
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

360 San Miguel Dr Ste 309
Newport Beach, CA 92660-7829
Phone: (949) 640-0434
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence C148028 (CA)
Dermatology Physician Taxonomy 207N00000X · Licence 52631431205 (UT)

Record details

NPI number1073571295
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 4, 2006
Last updated in NPPESJanuary 19, 2023
Certification dateJanuary 19, 2023

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