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NPI Code Detail

MEDICARE: DR. CHRISTOPHER JOHN PELLEGRINO JR. MD

MEDICARE: DR. CHRISTOPHER JOHN PELLEGRINO JR. MD
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
1208800000XUrology PhysicianA185811CA

General Provider Information

NPI Number : 1477189330
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER JOHN PELLEGRINO JR. MD
Provider Business Mailing Address
First Line : 23961 CALLE DE LA MAGDALENA STE 500
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-7622
Country : US
Telephone Number : 949-855-1101
Fax Number : 949-289-9171
Provider Business Practice Location Address
First Line : 23961 CALLE DE LA MAGDALENA STE 500
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-7622
Country : US
Telephone Number : 949-855-1101
Fax Number : 949-289-9171
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2020
Last Update Date : 06/16/2026

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