Provider Demographics
NPI:1912596727
Name:CANIA, BRIAN BARCELONA
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:BARCELONA
Last Name:CANIA
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 1:11512 BINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6738
Mailing Address - Country:US
Mailing Address - Phone:520-448-7553
Mailing Address - Fax:
Practice Address - Street 1:11512 BINGHAM ST
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-6738
Practice Address - Country:US
Practice Address - Phone:520-448-7553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95220782163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse