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Individual
MICHAEL ANTHONY CANCILLA JR.
Active
Individual
MICHAEL ANTHONY CANCILLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
PA15366
CA
363A00000X
Physician Assistant
Primary
PA15366
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA15366
—
CA
Enumeration date
08/09/2006
Last updated
03/21/2016
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