Organization
PETAR VUKASIN M D INC
Active
Organization
PETAR VUKASIN M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETAR VUKASIN M.D. (OWNER)
(818) 244-8161
Entity
Organization
Contact information
Practice address
222 W EULALIA ST STE 100A, GLENDALE, CA 91204-2850
(818) 244-8161
(818) 244-5122
Mailing address
222 W. EULALIA ST STE 100A, GLENDALE, CA 91204-2508
(818) 244-8161
(818) 244-5122
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G74237
CA
208C00000X
Colon & Rectal Surgery Physician
Primary
G74237
CA
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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