Healthcare Provider Details

I. General information

NPI: 1366460453
Provider Name (Legal Business Name): VITTORIO LAGANA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 ABBOTT ST 100
SALINAS CA
93901-4483
US

IV. Provider business mailing address

100 WILSON RD 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-751-7070
  • Fax: 831-751-7050
Mailing address:
  • Phone: 831-649-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: