Charles Robert Pettit
Otolaryngology/Facial Plastic Surgery
181 Andrieux St Ste 106
Sonoma
, California 95476-6920
Charles Robert Pettit
Otolaryngology/Facial Plastic Surgery
181 Andrieux St Ste 106
Sonoma
, California 95476-6920
(707) 581-1766
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About
Features
Specialties
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Charles Robert Pettit
- Po Box 4489
- Carmel, CA
- Zip : 93921-4489
- Fax : (707) 581-1766
- Phone : (707) 931-6485
Second Address
- Charles Robert Pettit
- 181 Andrieux St Ste 106
- Sonoma, CA
- Zip : 95476-6920
- Fax : (707) 581-1766
- Phone : (707) 931-6485
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A235594 | CA |
National Provider Identifier
| NPI | 1326183583 |
|---|---|
| Provider Name | Charles Robert Pettit |
| First Address | Carmel, CA 93921-4489 |
| Second Address | Sonoma, CA 95476-6920 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/02/2007 |
| Last Update Date | 15/07/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.