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Contact Information

MICHAEL A CANCILLA JR, PA
2020 J ST
SACRAMENTO, CA95811-3120
 Phone: 916-341-0576
 Fax: 916-498-9040
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Personal Emergency Response Attendant

146D00000X
Indicates primary specialty

NPI Profile & details for MICHAEL A CANCILLA JR · (Male)

NPI # 1952311052
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 08/09/2006
Last updated 03/21/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PA15366
  • CA Medicaid PA15366
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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