Provider Demographics
NPI:1225211725
Name:BIANCANI TRAINING AND PHYSICAL THERAPY
Entity Type:Organization
Organization Name:BIANCANI TRAINING AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BIANCANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-419-6054
Mailing Address - Street 1:4551 GATEWAY PARK BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2447
Mailing Address - Country:US
Mailing Address - Phone:916-419-6054
Mailing Address - Fax:916-419-6066
Practice Address - Street 1:4425C TREAT BLVD STE 243
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-2703
Practice Address - Country:US
Practice Address - Phone:925-685-4854
Practice Address - Fax:925-685-8720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33019174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04247ZMedicare Oscar/Certification