MEDICARE: JOANNE G PAGAL DO INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	20A7492	CA

General Provider Information

NPI Number	:	1073682225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOANNE G PAGAL DO INC.

Provider Business Mailing Address
First Line	:	25431 CABOT RD
Second Line	:	SUITE 115
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5518
Country	:	US
Telephone Number	:	949-448-9728
Fax Number	:	949-448-9732

Provider Business Practice Location Address
First Line	:	25431 CABOT RD
Second Line	:	SUITE 115
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5518
Country	:	US
Telephone Number	:	949-448-9728
Fax Number	:	949-448-9732

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JOANNE G PAGAL
Credential	:	D.O.
Telephone Number	:	949-448-9728

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	12/05/2012

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