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General NPI Number Information
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NPI Number | 1831557156
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Entity Type | Individual
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Provider Name | ANGELO CARLO GIANZON
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Gender | Male
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 02/01/2016
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Provider Practice Location Address
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Address Line | 1151 SONORA AVE APT 219
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City | GLENDALE
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State | CA
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Zip | 91201-3111
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Country | US
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Telephone | 818-561-9471
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 SONORA AVE APT 219
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City | GLENDALE
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State | CA
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Zip | 91201
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Country | US
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Telephone | 818-561-9471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 9924
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License Number State | CA
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