Individual
DR. JOHN ANTHONY VIGILANTE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1145 STURGIS ROAD, TWENTYNINE PALMS, CA 92278
(760) 830-2190
Mailing address
1145 STURGIS ROAD, TWENTYNINE PALMS, CA 92278
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101248164
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2009
Last updated
06/17/2022
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