Provider Demographics
NPI:1538141619
Name:TROIA-CANCIO, PAOLO VINCENZO (MD)
Entity Type:Individual
Prefix:DR
First Name:PAOLO
Middle Name:VINCENZO
Last Name:TROIA-CANCIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8733 EARLY TIMES LN
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CA
Mailing Address - Zip Code:95693-9687
Mailing Address - Country:US
Mailing Address - Phone:916-730-0680
Mailing Address - Fax:
Practice Address - Street 1:8110 LAGUNA BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8094
Practice Address - Country:US
Practice Address - Phone:916-683-3955
Practice Address - Fax:916-683-7290
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72026207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
H09770Medicare UPIN