Provider Demographics
NPI:1528156403
Name:GIAMPAOLI, MARTIN F (RPT)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:F
Last Name:GIAMPAOLI
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N SUNRISE AVE
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2916
Mailing Address - Country:US
Mailing Address - Phone:916-789-1384
Mailing Address - Fax:916-782-7113
Practice Address - Street 1:114 N SUNRISE AVE
Practice Address - Street 2:SUITE B-1
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2916
Practice Address - Country:US
Practice Address - Phone:916-789-1384
Practice Address - Fax:916-782-7113
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist