| Brenton Mikito Micah Kanno, | |
|
292 Reservation Rd, Marina, CA 93933-3110 | |
| (831) 883-8542 | |
| Not Available |
| Full Name | Brenton Mikito Micah Kanno |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 5 Years |
| Location | 292 Reservation Rd, Marina, California |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619546439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 300347 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Select Cal Physical Therapy Pc | 4789070699 | 130 |
| Provider Name | Marina Physical Therapy, Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1528223013 PECOS PAC ID: 1557405107 Enrollment ID: O20100219000431 |
| Provider Name | Select Cal Physical Therapy Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1417619008 PECOS PAC ID: 4789070699 Enrollment ID: O20220401000572 |
| Mailing Address | Practice Location Address |
|---|---|
| Brenton Mikito Micah Kanno, 201 Glenwood Cir Apt 13e, Monterey, CA 93940-6723 Ph: () - | Brenton Mikito Micah Kanno, 292 Reservation Rd, Marina, CA 93933-3110 Ph: (831) 883-8542 |
Jane Hong, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 114 Lakewood Dr, Marina, CA 93933 Phone: 831-521-3865 | |
Mr. Arthur Philip Zayas Villanueva, PTDPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 269 Reservation Rd Apt 110, Marina, CA 93933 Phone: 831-220-5327 | |
Miss Laurie James Gundlach, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 201 9th St, Marina, CA 93933 Phone: 504-909-0074 | |
William Frederick Manchester, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 445 Reservation Rd, Suite A, Marina, CA 93933 Phone: 831-883-8542 Fax: 831-883-8526 | |
Neil Franklin Hofbauer, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 201 9th St, Marina, CA 93933 Phone: 831-884-1097 | |
Sasha Geisler, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 445 Reservation Rd Ste F, Marina, CA 93933 Phone: 831-583-8747 |