Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shane Petrites, MD

Individual provider Emergency Medicine Physician · NPI 1275020307

Dr. Shane Petrites, MD is an Emergency Medicine Physician in Oakland, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1411 E 31st Street Qic 22123
Oakland, CA 94602
Phone: (510) 437-4564
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence A166937 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1275020307
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 14, 2018
Last updated in NPPESMay 20, 2022
Certification dateMay 20, 2022
Mailing address1411 East 31st Street Qic 22123, Oakland, CA 94602

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