Provider Demographics
NPI:1821733999
Name:CADIZ, IAN CARLO BIACO (MD)
Entity type:Individual
Prefix:
First Name:IAN CARLO
Middle Name:BIACO
Last Name:CADIZ
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 1:1287 ABERDEEN AVE
Mailing Address - Street 2:
Mailing Address - City:WINNIPEG
Mailing Address - State:MANITOBA
Mailing Address - Zip Code:R2X 1T7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:311 W I ST # B
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-3479
Practice Address - Country:US
Practice Address - Phone:209-826-2222
Practice Address - Fax:209-826-2599
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA201310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine