Provider Demographics
NPI:1265599815
Name:PAGLIANO, WILLIAM DENNIS
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DENNIS
Last Name:PAGLIANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24355 LYONS AVE
Mailing Address - Street 2:110
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2300
Mailing Address - Country:US
Mailing Address - Phone:661-255-6258
Mailing Address - Fax:661-255-5142
Practice Address - Street 1:24355 LYONS AVE
Practice Address - Street 2:110
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2300
Practice Address - Country:US
Practice Address - Phone:661-255-6258
Practice Address - Fax:661-255-5142
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1517213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E15170Medicaid
CA000E15170Medicaid
CAE1517Medicare ID - Type Unspecified