Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD60349148 | WA |
Y | 2080P0202X | Pediatric Cardiologist | MD60349148 | WA |
NPI | 1023261989 |
---|---|
Provider Name | Christopher Anthony Bellotti |
First Address | Orange, CA 92868-4929 |
Second Address | Tacoma, WA 98405-4292 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2008 |
Last Update Date | 12/06/2014 |