Stacy Petersen Medical Group, P.c.

Ophthalmology · Riverside, CA

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At a glance

4445 Magnolia Ave, Riverside, CA 92501

NPPES record updated Feb 12, 2026. Public records can lag behind changes at a practice.

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Practice location

4445 Magnolia Ave
Riverside, CA 92501

Professional details: NPI, taxonomy & registry record

NPI1194677955

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Registry details

Primary taxonomy: Ophthalmology
Taxonomy code: 207W00000X
Enumeration date: Feb 12, 2026
Record updated: Feb 12, 2026

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Ophthalmology

207W00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

4445 Magnolia Ave
Riverside, CA 92501

Phone: (949) 991-4172
Fax: (949) 288-0429

Mailing address

26791 ALISO CREEK RD # 1018

ALISO VIEJO, CA 926562887

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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