Healthcare Provider Details

I. General information

NPI: 1255675104
Provider Name (Legal Business Name): LAGS SPINE & SPORTSCARE MEDICAL CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W MAIN ST
VISALIA CA
93291-5920
US

IV. Provider business mailing address

135 CARMEN LN
SANTA MARIA CA
93458-7729
US

V. Phone/Fax

Practice location:
  • Phone: 559-272-1295
  • Fax: 559-272-1295
Mailing address:
  • Phone: 805-928-7361
  • Fax: 805-928-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCIS P LAGATTUTA
Title or Position: PRESIDENT
Credential: MD
Phone: 805-928-7361