Provider Demographics
NPI:1780980458
Name:ZIGNAGO, GIACOMO (IDMT)
Entity type:Individual
Prefix:
First Name:GIACOMO
Middle Name:
Last Name:ZIGNAGO
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 LEISURE TOWN RD APT 49
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9435
Mailing Address - Country:US
Mailing Address - Phone:916-715-5355
Mailing Address - Fax:
Practice Address - Street 1:6801 LEISURE TOWN RD APT 49
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-9435
Practice Address - Country:US
Practice Address - Phone:916-715-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians