Petar Vukasin M D Inc

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

G74237 Issued in CA

Legal business name

PETAR VUKASIN M D INC

Practice address

222 W Eulalia St Ste 100a
Glendale, CA 91204-2850

Phone

(818) 244-8161

Fax

(818) 244-5122

NPI assigned

Apr 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Petar Vukasin, M.D.NPI 1659385516

Title

Owner

Phone

(818) 244-8161

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Petar Vukasin, M.D.

  • Colon & Rectal Surgery Physician
  • Glendale, CA
  • NPI 1659385516
  Medicare reassignment Care Compare group NPD Authorized official
• Anamaria McElrath-Garza, M.D.

  • Colon & Rectal Surgery Physician
  • Glendale, CA
  • NPI 1720289044
  Medicare reassignment Care Compare group NPD
• Dena Rafiq Nasir, MD

  • Colon & Rectal Surgery Physician
  • Glendale, CA
  • NPI 1083272819
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1528359304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W. EULALIA ST STE 100A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042508",
            "telephone_number": "818-244-8161",
            "fax_number": "818-244-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST STE 100A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042850",
            "telephone_number": "818-244-8161",
            "fax_number": "818-244-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETAR VUKASIN M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "VUKASIN",
        "authorized_official_first_name": "PETAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-244-8161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G74237",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "G74237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.