Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 58890 | CA |
N | 1223P0700X | Prosthodontist | 58890 | CA |
NPI | 1235263278 |
---|---|
Provider Name | Andrew Robert Chapokas |
First Address | San Diego, CA 92103-4112 |
Second Address | San Diego, CA 92103-4112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 26/07/2011 |