Individual
HOWARD DAVID PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
Mailing address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A104136
CA
207R00000X
Internal Medicine Physician
A104136
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0043790
—
CA
01
—
ZZZ21572Z
MEDICARE PTAN FOR ALL OFFICE LOCATIONS UNDER BAZ, ALLERGY, ASTHMA &SINUS CENTER
CA
Enumeration date
04/30/2008
Last updated
06/23/2015
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