Provider Demographics
NPI:1437821907
Name:FERNANDES DA SILVA CARDOSO, GIOVANNI (CMT)
Entity Type:Individual
Prefix:MR
First Name:GIOVANNI
Middle Name:
Last Name:FERNANDES DA SILVA CARDOSO
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CORALTREE LN
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-4800
Mailing Address - Country:US
Mailing Address - Phone:424-452-8852
Mailing Address - Fax:
Practice Address - Street 1:4640 DEL AMO BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1939
Practice Address - Country:US
Practice Address - Phone:310-800-1418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist