Charles R Pettit (NPI# 1326183583, PAC ID# 6507873395) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1326183583 |
| PAC ID by PECOS | 6507873395 |
| Professional Enrollment ID | I20060320000654 |
| Full Name | Charles R Pettit |
| Address |
175 Concourse Blvd Santa Rosa CA 95403-8217 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE |
| Graduation Year | 1968 |
| Primary Specialty | OTOLARYNGOLOGY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050090 | SONOMA VALLEY HOSPITAL |
| 050145 | COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA |
| 051321 | HEALDSBURG DISTRICT HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 175 Concourse Blvd, Santa Rosa, CA 95403-8217 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Street Address |
175 CONCOURSE BLVD |
| City | SANTA ROSA |
| State | CA |
| Zip | 95403-8217 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ellen Barnett | Family Medicine | Integrative Medical Clinic of Santa Rosa, A Professional Corporation | 175 Concourse Blvd, Santa Rosa, CA 95403-8217 |
| Frank R Wilbur | Chiropractic | 175 Concourse Blvd, Santa Rosa, CA 95403-8217 | |
| Tess M Lusher | Psychiatry | 175 Concourse Blvd, Santa Rosa, CA 95403-8217 | |
| Robert B Dozor | Family Medicine | Integrative Medical Clinic of Santa Rosa, A Professional Corporation | 175 Concourse Blvd, Santa Rosa, CA 95403-8217 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maayan E Lieberman | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Anthony K Boyce | Family Medicine | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Elisabeth H Brittell | Psychologist, Clinical | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Olga G Sokolova | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Christine L Bilbrey | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Fredysha S Mcdaniel | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Emily L Porch | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Armand Braun | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Sonya M Kelly | Psychologist, Clinical | 3558 Round Barn Blvd, Suite 200, Santa Rosa, CA 95403-0991 | |
| Alison B Valdovinos | Clinical Psychologist | 3558 Round Barn Blvd, Santa Rosa, CA 95403-0991 | |
| Find all physicians in zip 95403 | |||
| City | SANTA ROSA |
| Zip Code | 95403 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | SANTA ROSA + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Charles R Pettit.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.