Individual
JOHN FRANK FRAGOLA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 843-5111
(818) 847-3935
Mailing address
101 S 1ST ST, 1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G49141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G491410
BLUE SHIELD
CA
05
—
00G491410
—
CA
Enumeration date
07/25/2006
Last updated
07/08/2007
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