MEDICARE: DR. JAMIE CINOTTO DPT

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	225100000X	Physical Therapist	70015230	IL
2	225100000X	Physical Therapist	35961	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1633794	OTHER	IL	BCBS OF ILLINOIS

General Provider Information

NPI Number	:	1568577088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE CINOTTO DPT

Provider Business Mailing Address
First Line	:	3271 S HIGUERA ST STE 102
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-1205
Country	:	US
Telephone Number	:	805-782-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3271 S HIGUERA ST STE 102
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-1205
Country	:	US
Telephone Number	:	805-782-9300
Fax Number	:

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	05/22/2023

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