Healthcare Provider Details

I. General information

NPI: 1669465266
Provider Name (Legal Business Name): JOSEPH CELESTINO PETRINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 01/28/2023
Certification Date: 01/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E ROMIE LN
SALINAS CA
93901-4208
US

IV. Provider business mailing address

416B MAIN ST
SALINAS CA
93901-3306
US

V. Phone/Fax

Practice location:
  • Phone: 831-424-8072
  • Fax: 318-424-6329
Mailing address:
  • Phone: 831-800-7887
  • Fax: 831-998-7155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG35662
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: