Provider Demographics
NPI:1104548650
Name:CACCIAMANI, GIOVANNI (MD)
Entity type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:
Last Name:CACCIAMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 S BERENDO ST APT 722
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1783
Mailing Address - Country:US
Mailing Address - Phone:626-491-1531
Mailing Address - Fax:
Practice Address - Street 1:1441 EASTLAKE AVE STE 7416
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-1020
Practice Address - Country:US
Practice Address - Phone:626-491-1531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study