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Individual

MICHAEL ALLEN PETRELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1 DISPENSARY ROAD, POINT MUGU NAWC, CA 93042-0001
(805) 989-8815
Mailing address
1 DISPENSARY ROAD, POINT MUGU NAWC, CA 93042-5017
(805) 989-7213

Taxonomy

Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
22738
CA
208D00000X
General Practice Physician
009132
AZ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
01/10/2020
Last updated
09/10/2024
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