Provider Demographics
NPI:1629223235
Name:PANEBIANCO, ANTHONY G (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:G
Last Name:PANEBIANCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 BECHELLI LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2466
Mailing Address - Country:US
Mailing Address - Phone:530-221-9300
Mailing Address - Fax:
Practice Address - Street 1:3400 BECHELLI LN
Practice Address - Street 2:SUITE A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2466
Practice Address - Country:US
Practice Address - Phone:530-221-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor