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Individual

JOHN FRANCIS PETRAGLIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1601 DOVE ST, SUITE 170, NEWPORT BEACH, CA 92660-2433
(949) 474-7246
(949) 474-7247
Mailing address
PO BOX 3969, CERRITOS, CA 90703-3969
(562) 407-2080
(562) 407-2082

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G68169
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
G68169
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G681690
CA
Enumeration date
12/16/2005
Last updated
04/12/2011
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