Individual
ROBERT T. PETRUZZO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4405 VANDEVER AVE, SAN DIEGO, CA 92120-3315
(619) 528-5000
Mailing address
1153 PINE DR, EL CAJON, CA 92020-7248
(000) 000-0000
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
20A4255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX42550
—
CA
Enumeration date
01/17/2007
Last updated
04/28/2008
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