Individual
DR. JOHN PATRICK FANTAUZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, SUITE 203, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
233230
NY
2085R0202X
Diagnostic Radiology Physician
Primary
C208770
CA
2085R0202X
Diagnostic Radiology Physician
D0066858
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03091572
—
NY
Enumeration date
03/26/2008
Last updated
05/01/2026
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