Provider Demographics
NPI:1063702009
Name:ZANONI, LUCIANO GERMAN
Entity type:Individual
Prefix:MR
First Name:LUCIANO
Middle Name:GERMAN
Last Name:ZANONI
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 1:450 W BARNARD ST APT D144
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-1585
Mailing Address - Country:US
Mailing Address - Phone:760-670-9361
Mailing Address - Fax:
Practice Address - Street 1:450 W BARNARD ST APT D144
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1585
Practice Address - Country:US
Practice Address - Phone:760-670-9361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program