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Individual

DANIEL R PONTICIELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
26800 CROWN VALLEY PKWY STE 205, MISSION VIEJO, CA 92691-6384
(949) 364-3330
(949) 364-2886
Mailing address
26522 LA ALAMEDA, SUITE 120, MISSION VIEJO, CA 92691-6330
(949) 282-1671
(949) 367-0518

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
253745
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A120221
CA

Other

Enumeration date
06/30/2009
Last updated
10/28/2020
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