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Individual

ANNA ALEKSEEVNA PETROVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
6555 COYLE AVE, CARMICHAEL, CA 95608-0302
(916) 536-2500
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A8324
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000810608129
PHCS
CA
05
00AX83240
CA
01
106126
HEALTH NET
CA
01
1806844
GREAT WEST
CA
01
20A8324
BLUE CROSS
CA
01
2238002
FIRST HEALTH
CA
01
236152
INTERPLAN
CA
01
4441911
CIGNA
CA
01
5635513
FIRSTH HEALTH
CA
01
7403659
AETNA
CA
01
90141470
PACIFICARE
CA
01
MCMG343900
WESTERN HEALTH ADVANTAGE
CA
Enumeration date
09/26/2006
Last updated
02/13/2012
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