Healthcare Provider Details

I. General information

NPI: 1043267834
Provider Name (Legal Business Name): MICHAEL VINCENT BIGAY P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 03/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 JUNIPER CT
STANTON CA
90680-3187
US

IV. Provider business mailing address

35 JUNIPER CT
STANTON CA
90680-3187
US

V. Phone/Fax

Practice location:
  • Phone: 626-321-7210
  • Fax:
Mailing address:
  • Phone: 626-321-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT30171
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: