Provider Demographics
NPI:1336196583
Name:ARAGONA, JODI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:LYNN
Last Name:ARAGONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:ARAGONA LUKACSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60039
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-6039
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-447-6057
Practice Address - Street 1:1420 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2508
Practice Address - Country:US
Practice Address - Phone:818-502-2344
Practice Address - Fax:818-502-4501
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60983207P00000X
FLME100638207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A609830OtherBLUE SHIELD
CA00A609830Medicaid
CAA60983OtherBLUE CROSS
CAA60983OtherBLUE CROSS
00A609830OtherBLUE SHIELD
CAWA60983CMedicare PIN
G71013Medicare UPIN