Organization
JOHN PETRAGLIA M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN F PETRAGLIA M.D. (PRESIDENT)
(562) 407-2080
Entity
Organization
Contact information
Practice address
14120 ALONDRA BLVD, SUITE C, SANTA FE SPRINGS, CA 90670-5820
(562) 407-2080
Mailing address
PO BOX 4259, CERRITOS, CA 90703-4259
(562) 407-2080
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G68169
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G681691
—
CA
Enumeration date
07/30/2007
Last updated
07/30/2007
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