Provider Demographics
NPI:1699574673
Name:PIZANO, ELIA
Entity type:Individual
Prefix:
First Name:ELIA
Middle Name:
Last Name:PIZANO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BROADWAY ST STE 70
Mailing Address - Street 2:
Mailing Address - City:KING CITY
Mailing Address - State:CA
Mailing Address - Zip Code:93930-2866
Mailing Address - Country:US
Mailing Address - Phone:831-386-6868
Mailing Address - Fax:831-386-6843
Practice Address - Street 1:200 BROADWAY ST STE 70
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930-2866
Practice Address - Country:US
Practice Address - Phone:831-386-6805
Practice Address - Fax:831-386-6843
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker