Dana Petrus, M.D., INC.
Family Medicine in Apple Valley, CA. Organization (NPI-2).
NPI number1164596896
StatusActive
Last updated in NPPESJul 22, 2009
Details
- NPI
- 1164596896
- Entity type
- Organization (NPI-2)
- Legal business name
- Dana Petrus, M.D., INC.
- Organization subpart
- No
- Enumeration date
- Nov 17, 2006
- Last updated
- Jul 22, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | A79858 | CA | Yes |
Practice location
18031 Hwy 18Suite B
Apple Valley, CA 92307
Phone 760-242-7770 · Fax 760-242-7760
Mailing address
18031 Hwy 18Suite B
Apple Valley, CA 92307-0000
Phone 760-242-7770 · Fax 760-242-7760
Authorized official
Dana C Petrus
President
7602427770
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