Provider Demographics
NPI:1114220308
Name:MICHAEL C.CIANO, M.D. INC. AMC
Entity Type:Organization
Organization Name:MICHAEL C.CIANO, M.D. INC. AMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:CIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-497-8411
Mailing Address - Street 1:2190 LYNN RD STE 310
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8025
Mailing Address - Country:US
Mailing Address - Phone:805-497-8411
Mailing Address - Fax:805-496-5632
Practice Address - Street 1:2190 LYNN RD STE 310
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8025
Practice Address - Country:US
Practice Address - Phone:805-497-8411
Practice Address - Fax:805-496-5632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35437208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty