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LAURA NORTON PETROVICH MD PC NPI 1033368741


NPI Information

NPI: 1033368741
Provider Name: LAURA NORTON PETROVICH MD PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D1019412

Address:
1224 10TH ST
SUITE 200
CORONADO, CA
ZIP 92118
Phone: (619) 435-2234
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LAURA NORTON PETROVICH MD PC is a pediatrics in Coronado, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. LAURA NORTON PETROVICH MD PC NPI is 1033368741. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1224 10TH ST
SUITE 200
CORONADO, CA
ZIP 92118-416
Phone: (619) 435-2234
Fax: (619) 435-1784

The provider's authorized official is Laura Norton Petrovich .
The authorized official title is Owner/president and has the following contact phone number (619) 435-2234.

The CLIA number assigned to this NPI record is 05D1019412 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/17/2008 and was last updated on 2/8/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineA72085CALIFORNIANo
2208000000XPediatricsA72085CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A72085MEDICARE PINCALIFORNIA
2H72026MEDICARE UPINCALIFORNIA
300A720850MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.