Individual
MR. ALEXANDER PETRICEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44505 90TH ST W, LANCASTER, CA 93536-7705
(661) 726-2630
Mailing address
44447 10TH ST W, LANCASTER, CA 93534-3324
(661) 726-2630
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-FHTDKM
CA
Other
Enumeration date
12/11/2024
Last updated
05/08/2025
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