Provider Demographics
NPI:1942356258
Name:SIGNORELLI, PAUL VICTOR (MA, ATC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:VICTOR
Last Name:SIGNORELLI
Suffix:
Gender:M
Credentials:MA, ATC
Other - Prefix:
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Mailing Address - Street 1:5810 RILEY ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-1760
Mailing Address - Country:US
Mailing Address - Phone:619-840-4742
Mailing Address - Fax:
Practice Address - Street 1:5998 ALCALA PARK
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2476
Practice Address - Country:US
Practice Address - Phone:619-260-8895
Practice Address - Fax:619-260-4742
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer