Organization
BRUCE R. BRAGONIER, MD, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ROBERT BRAGONIER MD (PHYSICIAN/OWNER)
(707) 823-7602
Entity
Organization
Contact information
Practice address
555 PETALUMA AVE, STE B, SEBASTOPOL, CA 95472-4224
(707) 823-7602
(707) 823-7625
Mailing address
555 PETALUMA AVE, STE B, SEBASTOPOL, CA 95472-4224
(707) 823-7602
(707) 823-7625
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G75427
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G754270
—
CA
Enumeration date
04/22/2008
Last updated
01/07/2010
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