Individual
JASON PERAGALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1365B CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-5360
Mailing address
1365B CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-5360
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
67588
GA
207W00000X
Ophthalmology Physician
A116847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1168470
—
CA
Enumeration date
02/28/2011
Last updated
12/03/2020
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