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General NPI Number Information
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NPI Number | 1902085277
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Entity Type | Organization
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Legal Business Name | STEVEN J PETIT MD A M C
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 630 S RAYMOND AVE SUITE 240
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-449-9920
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Fax | 626-578-7366
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Provider Business Mailing Address
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Address Line | 630 S RAYMOND AVE SUITE 240
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-449-9920
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Fax | 626-578-7366
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANN MARIE CASELLA
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Credential |
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Telephone | 626-449-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G29872
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License Number State | CA
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