CHARLES ROBERT PETTIT MD A MEDICAL CORPORATION NPI 1316268386

NPI Information

CHARLES ROBERT PETTIT MD A MEDICAL CORPORATION is an otolaryngology/facial plastic surgery otolaryngology in Santa Rosa, CA. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. CHARLES ROBERT PETTIT MD A MEDICAL CORPORATION NPI is 1316268386. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

175 CONCOURSE BLVD
SANTA ROSA, CA
ZIP 95403-217
Phone: (707) 284-9200
Fax: (707) 284-9204

The provider's authorized official is Charles Robert Pettit .
The authorized official title is President and has the following contact phone number (707) 843-3999.

The enumeration date for this NPI number is 6/14/2010 and was last updated on 8/14/2015.

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:

Other Identifiers

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