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General NPI Number Information
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NPI Number | 1790774560
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Entity Type | Individual
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Provider Name | STEVEN PETRONIJEVIC DO
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Gender | Male
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 17615 MORO RD
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City | SALINAS
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State | CA
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Zip | 93907-8541
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Country | US
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Telephone | 831-663-3926
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Fax | 831-663-0605
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Provider Business Mailing Address
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Address Line | 17615 MORO RD
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City | SALINAS
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State | CA
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Zip | 93907-8541
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Country | US
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Telephone | 831-663-3926
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Fax | 831-663-0605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A5244
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License Number State | CA
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