Provider Demographics
NPI:1982718359
Name:CIGLIANO, JEAN (PT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:CIGLIANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 N ENROSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-2706
Mailing Address - Country:US
Mailing Address - Phone:310-832-2622
Mailing Address - Fax:
Practice Address - Street 1:28633 S WESTERN AVE STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0817
Practice Address - Country:US
Practice Address - Phone:310-832-2622
Practice Address - Fax:310-832-2621
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT8673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT8673Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER