Laura Norton Petrovich MD PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A72085 Issued in CA

Legal business name

LAURA NORTON PETROVICH MD PC

Practice address

1224 10TH St
Suite 200
Coronado, CA 92118-3416

Phone

(619) 435-2234

Fax

(619) 435-1784

NPI assigned

Sep 17, 2008

Last updated

Feb 8, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Laura Norton Petrovich, M.D.NPI 1891800116

Title

Owner/President

Phone

(619) 435-2234

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laura Norton Petrovich, MD

  • Internal Medicine Physician
  • Coronado, CA
  • NPI 1891800116
  Medicare reassignment NPD Authorized official
• Neha Athale, F.N.P.

  • Family Nurse Practitioner
  • Coronado, CA
  • NPI 1780018739
  NPD (past)
• Laura Lampe, NP

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1912390998
  NPD (past)
• Jennifer Lee Woodson, M.D.

  • Family Medicine Physician
  • Coronado, CA
  • NPI 1487842654
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1033368741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 10TH ST",
            "address_2": "SUITE 200",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921183416",
            "telephone_number": "619-435-2234",
            "fax_number": "619-435-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 10TH ST",
            "address_2": "SUITE 200",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921183416",
            "telephone_number": "619-435-2234",
            "fax_number": "619-435-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA NORTON PETROVICH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "NORTON",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "619-435-2234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72085",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A72085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A720850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wael Kouli, MD
• Taylor Kugel
• La Vita Real Estate LLC ('B' Street Plastic Surgery)
• Taylor Lanier, RN
• Kathryn Laroe, LCSW
• Lisa Marems Lazar, PHD
• Angie Lee, PHARM.D.
• Fernanda Lee, AMFT
• Garrick Nicholas Li, PT, DPT
• Shannon Louise Lis, CPNP

• Pediatrics Physician in Coronado, CA
• Providers in Coronado, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.