Search › California › 207P00000X
Shane Petrites, MD
NPI 1275020307 · on the registry since 2018 · sole proprietor
Practice
- Address
- 1411 East 31st Street Qic 22123
Oakland, CA 94602 - Phone
- (510) 437-4564
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 207P00000X
207P00000X
- Also registered as
- 390200000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-05-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California