Individual
DR. JOHN GREGORY DALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
801 S MAIN ST STE 101&205, CORONA, CA 92882-3402
(951) 238-6071
(951) 351-1025
Mailing address
PO BOX 101418, PASADENA, CA 91189-0025
(844) 866-2718
(310) 966-8571
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20A8441
CA
2085R0202X
Diagnostic Radiology Physician
54676
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX84410
—
CA
01
—
020A84410
BLUE SHIELD
CA
01
—
P00126987
RAILROAD
CA
Enumeration date
07/21/2005
Last updated
05/22/2024
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