ETHAN MERRILL PETERSEN
NPI 1821665936
Student in an Organized Health Care Education/Training Program in Torrance, CA
About Ethan Merrill Petersen NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN MERRILL PETERSEN (NPI 1821665936) is an individual student in an organized health care education/training program in Torrance, California and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ethan Merrill Petersen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TORRANCE, CA 90502
TORRANCE, CA 90502
TORRANCE, CA 90502
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ethan Petersen's NPI number?
The NPI number for Ethan Petersen is 1821665936. It was assigned to this individual provider in the NPPES registry on June 7, 2021.
Where is Ethan Petersen located?
Ethan Petersen practices at 1000 W Carson St, Torrance, CA 90502. The listed phone number is (424) 306-4000.
What is Ethan Petersen's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Ethan Petersen enrolled in Medicare?
Yes. Ethan Petersen is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Ethan Petersen was last updated on June 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ethan Merrill Petersen · NPI 1821665936
Student in an Organized Health Care Education/Training Program provider in Torrance, California. Individual provider, active in the CMS NPPES registry since June 7, 2021.
## Identity
- **NPI:** 1821665936 (Entity type: Individual)
- **Enumerated:** June 7, 2021
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1000 W CARSON ST, Torrance, CA 90502-2059
- **Phone:** (424) 306-4000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** June 20, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1821665936) · Data from the CMS NPPES public registry.