# SAN JOAQUIN VALLEY INTERVENTIONAL PAIN MEDICAL GROUP

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

## Provider details

- **NPI number:** 1710085014
- **Authorized official:** DR. JOHN FRANCIS PETRAGLIA M.D. (PRESIDENT)
- **Authorized official phone:** (562) 407-2080

## Contact information

- **Practice address:** 6210 N 1ST ST, FRESNO, CA 93710-5447
- **Practice address phone:** (562) 407-2080
- **Practice address fax:** (562) 407-2082
- **Mailing address:** PO BOX 3969, CERRITOS, CA 90703-3969
- **Mailing address phone:** (562) 407-2080
- **Mailing address fax:** (562) 407-2082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 06/11/2008