Organization
STEVEN J PETIT MD A M C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN MARIE CASELLA (OFFICE MANAGER)
(626) 449-9920
Entity
Organization
Contact information
Practice address
630 S RAYMOND AVE, SUITE 240, PASADENA, CA 91105-3278
(626) 449-9920
(626) 578-7366
Mailing address
630 S RAYMOND AVE, SUITE 240, PASADENA, CA 91105-3278
(626) 449-9920
(626) 578-7366
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G29872
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G298720
—
CA
01
—
DH1142
RAILROAD MEDICARE PTAN
CA
Enumeration date
11/02/2007
Last updated
06/17/2009
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