Healthcare Provider Details

I. General information

NPI: 1003829409
Provider Name (Legal Business Name): PETER ALAGONA JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 COMMERCE DR
BAKERSFIELD CA
93309-0631
US

IV. Provider business mailing address

5251 OFFICE PARK DR STE. 202
BAKERSFIELD CA
93309-0404
US

V. Phone/Fax

Practice location:
  • Phone: 661-324-4100
  • Fax: 661-324-4600
Mailing address:
  • Phone: 661-829-0074
  • Fax: 661-200-7783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD019626E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG133729
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: