Provider Demographics
NPI:1881202166
Name:TIANO, DANIEL GLENN (DPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:GLENN
Last Name:TIANO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30030 SUNRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1500
Mailing Address - Country:US
Mailing Address - Phone:661-414-2522
Mailing Address - Fax:
Practice Address - Street 1:30030 SUNRIDGE PL
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-1500
Practice Address - Country:US
Practice Address - Phone:661-414-2522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT298434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist