Provider Demographics
NPI:1043267834
Name:BIGAY, MICHAEL VINCENT (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:VINCENT
Last Name:BIGAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JUNIPER CT
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-3187
Mailing Address - Country:US
Mailing Address - Phone:626-321-7210
Mailing Address - Fax:
Practice Address - Street 1:35 JUNIPER CT
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-3187
Practice Address - Country:US
Practice Address - Phone:626-321-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT30171AMedicare ID - Type UnspecifiedMEMBER ID FOR W17927 GRP
CAWPT30171BMedicare ID - Type UnspecifiedMEMBER ID FOR W17927A GRP