# BRUCE R. BRAGONIER, MD, A PROFESSIONAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578737441
- **Authorized official:** DR. BRUCE ROBERT BRAGONIER MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (707) 823-7602

## Contact information

- **Practice address:** 555 PETALUMA AVE, STE B, SEBASTOPOL, CA 95472-4224
- **Practice address phone:** (707) 823-7602
- **Practice address fax:** (707) 823-7625
- **Mailing address:** 555 PETALUMA AVE, STE B, SEBASTOPOL, CA 95472-4224
- **Mailing address phone:** (707) 823-7602
- **Mailing address fax:** (707) 823-7625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G75427 | CA | Yes |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 01/07/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G754270 | — | CA |