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General NPI Number Information
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NPI Number | 1851583553
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Entity Type | Individual
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Provider Name | KATHLEEN BIANCO PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 2140 GRAND AVE STE 125
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City | CHINO HILLS
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State | CA
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Zip | 91709-6802
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Country | US
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Telephone | 909-630-7875
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Fax | 909-469-2107
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Provider Business Mailing Address
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Address Line | 1601 MONTE VISTA AVE STE 260
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City | CLAREMONT
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State | CA
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Zip | 91711-6604
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Country | US
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Telephone | 909-865-9501
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Fax | 909-469-2146
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17139
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License Number State | CA
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