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Export Provider Record NPI 1003120452
Kimberly Peterson, O.d., Inc.
Organization Subpart: NO
Active
NPI Number1003120452
NPI TypeNPI-2 Organization
SpecialtyOptometrist
Provider Details
NPI1003120452
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2010-07-27
Last Updated2010-07-27
Authorized OfficialKimberly Peterson
owner
Phone: 9094213030
Mailing Address1850 N Riverside Ave, Suite 100
Rialto, CA 92376-8071
United States
Phone: (909) 421-3030 | Fax: (909) 421-3059
📍 View Map
Primary Practice Address1850 N Riverside Ave, Suite 100
Rialto, CA 92376-8071
United States
Phone: (909) 421-3030 | Fax: (909) 421-3059
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes152W00000X – OptometristCA11094T
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About NPI 1003120452

Kimberly Peterson, O.d., Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1003120452. The primary specialty listed is Optometrist. The organization is located in Rialto, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2010-07-27. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1003120452?

NPI 1003120452 belongs to Kimberly Peterson, O.d., Inc., a Optometrist in Rialto, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1003120452 active?

The current status of NPI 1003120452 in the NPPES registry is Active. The record was last updated on 2010-07-27.

What specialty is NPI 1003120452?

NPI 1003120452 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1003120452?

You can verify NPI 1003120452 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1003120452?

The primary practice address on file for NPI 1003120452 is 1850 N Riverside Ave, Rialto, CA 92376-8071. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1003120452 issued?

NPI 1003120452 was first issued (enumerated) on 2010-07-27. The NPPES record was last updated on 2010-07-27.

Practice Location Map

Kimberly Peterson, O.d., Inc. is located at 1850 N Riverside Ave, Rialto, CA. Use the map below to find directions or verify the practice location.

📍 1850 N Riverside Ave, Rialto, CA 92376-8071  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Kimberly Peterson, O.d., Inc.. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1003120452. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Optometrist11094TCA
Data Verified from CMS NPPES Last synced: 2026-06-05 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162