Basic Information
| Provider Information | |||||||||
| NPI: | 1003804089 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PETRONIJEVIC | ||||||||
| FirstName: | CATHERINE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17615 MORO RD | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939078541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316633926 | ||||||||
| FaxNumber: | 8316630605 | ||||||||
| Practice Location | |||||||||
| Address1: | 17615 MORO RD | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939078541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316633926 | ||||||||
| FaxNumber: | 8316630605 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 05/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A55360 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.