Individual
ERNESTINE R PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 N VERMONT AVE, LOS ANGELES, CA 90027-6098
(213) 413-3000
(323) 666-2939
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(714) 347-1000
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G71691
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G716910
—
CA
Enumeration date
02/13/2007
Last updated
08/17/2018
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