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Contact Information

SHANE PETRITES, MD
1411 EAST 31ST STREET QIC 22123
OAKLAND, CA94602
 Phone: 510-437-4564
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for SHANE PETRITES · (Male)

NPI # 1275020307
Status Active
Credentials MD
Entity Individual
Enumeration date 04/14/2018
Last updated 05/20/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A166937
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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