Provider Demographics
NPI:1225204845
Name:DELGADO, JOHN ML (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ML
Last Name:DELGADO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:375 ROLLING OAKS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1027
Mailing Address - Country:US
Mailing Address - Phone:805-497-9481
Mailing Address - Fax:805-497-9001
Practice Address - Street 1:375 ROLLING OAKS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1027
Practice Address - Country:US
Practice Address - Phone:805-497-9481
Practice Address - Fax:805-497-9001
Is Sole Proprietor?:No
Enumeration Date:2008-05-03
Last Update Date:2015-08-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC136480207X00000X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C136480Medicare PIN