San Joaquin Valley Interventional Pain Medical Group

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

SAN JOAQUIN VALLEY INTERVENTIONAL PAIN MEDICAL GROUP

Practice address

6210 N 1St St
Fresno, CA 93710-5447

Phone

(562) 407-2080

Fax

(562) 407-2082

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Francis Petraglia, M.D.

Title

President

Phone

(562) 407-2080

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1710085014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3969",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907033969",
            "telephone_number": "562-407-2080",
            "fax_number": "562-407-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105447",
            "telephone_number": "562-407-2080",
            "fax_number": "562-407-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN VALLEY INTERVENTIONAL PAIN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "PETRAGLIA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-407-2080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Courtney Samuelson Visher, RD
• San Joaquin Accident and Medical Group, Inc.
• San Joaquin Medical Transportation Inc
• San Joaquin Totalcare
• San Joaquin Valley Imaging Services, Inc
• Michele Gonzales San Jose, RN
• San Lorenzo Home Health (Home Health Agency)
• Austin San
• Socheata San
• Sanagaram S. Shantharam M.D. Inc.

• Pain Medicine (Anesthesiology) Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.