Individual
MR. CHRISTIANNE MARIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1695 KINGMAN AVE, SAN JOSE, CA 95128-2828
(408) 280-7573
Mailing address
1695 KINGMAN AVE, SAN JOSE, CA 95128-2828
(408) 280-7573
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D1417598
CA
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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