Provider Demographics
NPI:1336206986
Name:WILLIAM DENNIS PAGLIANO, DPM INC.
Entity type:Organization
Organization Name:WILLIAM DENNIS PAGLIANO, DPM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:PAGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:213-481-1888
Mailing Address - Street 1:1245 WILSHIRE BLVD
Mailing Address - Street 2:810
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-4810
Mailing Address - Country:US
Mailing Address - Phone:213-481-1888
Mailing Address - Fax:213-481-2025
Practice Address - Street 1:1245 WILSHIRE BLVD
Practice Address - Street 2:810
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4810
Practice Address - Country:US
Practice Address - Phone:213-481-1888
Practice Address - Fax:213-481-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1517213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E15170Medicaid
CAT19115Medicare UPIN
CAE1517Medicare ID - Type Unspecified