Gregory Petty in San Diego - Physician Assistant
Gregory Petty - NPI 1558557785
Gregory Petty is a Physician Assistant in San Diego, California. Gregory Petty practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Gregory Petty is 1558557785. The last update date is 2015-02-23.
Gregory Petty's current location address is 3350 La Jolla Village Dr, San Diego, California. You can contact this provider via phone number 8585528585. The mailing address for Gregory Petty is 3350 La Jolla Village Dr, San Diego, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory Petty |
|---|---|
| Address | 3350 La Jolla Village Dr, San Diego, California |
| Phone Number | 8585528585 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1558557785 |
|---|---|
| Provider Enumeration Date | 2007-09-21 |
| Last Updated Date | 2015-02-23 |
Provider Mailing Address Detail
| Address | 3350 La Jolla Village Dr |
|---|---|
| City | San Diego |
| State | California (CA) |
| Post Code | 921610002 |
| Phone Number | 8585528585 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5159 |
|
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 58-2155150 | GA | COMPANY TAX ID |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Gregory Petty by the Centers for Medicare & Medicaid Services?
The Gregory Petty has been assigned the NPI (National Provider Identifier) 1558557785 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Gregory Petty is physically located?
The Gregory Petty is situated at the following address: 3350 La Jolla Village Dr, San Diego, CA 921610002.
What is the Gregory Petty's area of specialization and corresponding taxonomy classification?
The Gregory Petty's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1558557785 to Gregory Petty?
The Centers for Medicare & Medicaid Services originally issued the 1558557785 to Gregory Petty on 2007-09-21.
When was the Gregory Petty's information last updated?
The Gregory Petty's information was last updated on 2015-02-23.
NPI Number: 1871596916
Address: 2201 Brooken Hill Dr, Fort Smith, AR
NPI Number: 1912900044
Address: 2201 Brooken Hill Dr, Fort Smith, AR
NPI Number: 1073517967
Address: 17815 Ventura Blvd, Encino, CA
NPI Number: 1225032253
Address: 3939 Medical Dr Ste 110, San Antonio, TX
NPI Number: 1568466506
Address: 3939 Medical Dr, San Antonio, TX