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General NPI Number Information
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NPI Number | 1336448299
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Entity Type | Organization
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Legal Business Name | JAMES PETROS, M.D., INC.
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 14777 LOS GATOS BLVD STE 201
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City | LOS GATOS
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State | CA
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Zip | 95032-2059
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Country | US
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Telephone | 408-528-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 1604 BLOSSOM HILL RD STE 10
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City | SAN JOSE
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State | CA
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Zip | 95124-6350
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Country | US
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Telephone | 408-528-8833
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Fax | 408-528-8557
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. JAMES PETROS
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Credential | MD
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Telephone | 408-528-8833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | A90732
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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