Provider Demographics
NPI:1669465266
Name:PETRINI, JOSEPH CELESTINO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CELESTINO
Last Name:PETRINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:416B MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3306
Mailing Address - Country:US
Mailing Address - Phone:831-800-7887
Mailing Address - Fax:831-998-7155
Practice Address - Street 1:720 E ROMIE LN
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4208
Practice Address - Country:US
Practice Address - Phone:831-424-8072
Practice Address - Fax:318-424-6329
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2023-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA75533318Medicaid
CA00G356620Medicare ID - Type Unspecified
CA75533318Medicaid