Organization
CHARLES ROBERT PETTIT MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ROBERT PETTIT M.D. (PRESIDENT)
(707) 843-3999
Entity
Organization
Contact information
Practice address
175 CONCOURSE BLVD, SANTA ROSA, CA 95403-8217
(707) 284-9200
(707) 284-9204
Mailing address
3906 HEATHFIELD PL, SANTA ROSA, CA 95404-7627
(707) 843-3999
(707) 545-3999
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/14/2010
Last updated
08/14/2015
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