MEDICARE: TERESA DELATOLLA FIANO PT

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	174400000X	Specialist	PT32302	CA

General Provider Information

NPI Number	:	1528309754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA DELATOLLA FIANO PT

Provider Business Mailing Address
First Line	:	34426 VIA GOMEZ
Second Line	:
City	:	CAPISTRANO BEACH
State	:	CA
Zip	:	92624-1319
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 AVENIDA PICO
Second Line	:	SUITE 201
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92673-6352
Country	:	US
Telephone Number	:	949-388-8788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2013
Last Update Date	:	09/13/2016

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