Provider Demographics
NPI:1073622080
Name:FLORINDA MAILOM PIANO, MD, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:FLORINDA MAILOM PIANO, MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORINDA
Authorized Official - Middle Name:MAILOM
Authorized Official - Last Name:PIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-955-8877
Mailing Address - Street 1:2121 W MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1706
Mailing Address - Country:US
Mailing Address - Phone:818-955-8877
Mailing Address - Fax:818-955-8845
Practice Address - Street 1:2121 W MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1706
Practice Address - Country:US
Practice Address - Phone:818-955-8877
Practice Address - Fax:818-955-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56267207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14811Medicare UPIN
CAWA56267BMedicare ID - Type Unspecified