Provider Demographics
NPI:1609881580
Name:PETROFF, HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:
Last Name:PETROFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 MARICOPA HWY STE C
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3170
Mailing Address - Country:US
Mailing Address - Phone:805-640-0068
Mailing Address - Fax:805-640-1749
Practice Address - Street 1:1202 MARICOPA HWY
Practice Address - Street 2:SUITE C
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-3169
Practice Address - Country:US
Practice Address - Phone:805-640-0068
Practice Address - Fax:805-640-1749
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90925207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A90925Medicaid
CAWA90925AMedicare PIN
CAWA90925BMedicare PIN