Individual
PETER DANIEL JURISICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2 MEDICAL PLAZA DR STE 175, ROSEVILLE, CA 95661-3049
(916) 782-2146
Mailing address
2 MEDICAL PLAZA DR STE 175, ROSEVILLE, CA 95661-3049
(916) 782-2146
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20A8542
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
20A8542
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810778930
PHCS
CA
05
—
00AX85420
—
CA
01
—
020A85420
BLUE SHIELD
CA
01
—
102287
HEALTH NET
CA
01
—
1671625
GREAT WEST
CA
01
—
20A542
BLUE CROSS
CA
01
—
2121684
FIRST HEALTH
CA
01
—
2361104
UNITED HEALTHCARE
CA
01
—
4911481
CIGNA
CA
01
—
7450546
AETNA
CA
01
—
90136861
PACIFICARE
CA
01
—
95883
INTERPLAN
CA
Enumeration date
07/30/2006
Last updated
02/28/2014
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