Pendleton, John
Pendleton, John is an individual health care provider with primary practice located at 1179 N Mcdowell Blvd , Petaluma CA 94954-6559. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pendleton, John can be contacted via phone (707) 559-7500.Contact Information
Primary practice address
1179 N Mcdowell Blvd
Petaluma CA 94954-6559
Phone: (707) 559-7500
Fax: (707) 559-7620
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A91072 | California |
Profile Details
| NPI number | 1326030024 |
|---|---|
| LBN Legal business name | Pendleton, John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Sep 20th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326030024 | NPPES |
| California | MEDICAID | FHC70696F | |
| California | MEDICAID | 1326030024 | |
| California | MEDICAID | BCP70696F | |
| California | Other | ZZZ18742Z | |
| California | MEDICAID | HAP70696F |
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