| Dana Petrus, M.d., Inc. | |
|
18031 Hwy 18 Suite B Apple Valley CA 92307 | |
| (760) 242-7770 | |
| (760) 242-7760 |
| Full Name | Dana Petrus, M.d., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 18031 Hwy 18, Apple Valley, California |
| Authorized Official Name and Position | Dana C Petrus (PRESIDENT) |
| Authorized Official Contact | 7602427770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dana Petrus, M.d., Inc. 18031 Hwy 18 Suite B Apple Valley CA 92307-0000 Ph: (760) 242-7770 | Dana Petrus, M.d., Inc. 18031 Hwy 18 Suite B Apple Valley CA 92307 Ph: (760) 242-7770 |
| NPI Number | 1164596896 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 07/22/2009 |
| Medicare PECOS PAC ID | 2567460785 |
|---|---|
| Medicare Enrollment ID | O20061127000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164596896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A79858 (California) | Primary |
| Provider Name | Dana C Petrus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851391080 PECOS PAC ID: 1557350113 Enrollment ID: I20040510000082 |
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