Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 33972 | SC |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | F5720 | CA |
NPI | 1659669232 |
---|---|
Provider Name | Dr. Alkiviadis James Psaltis |
First Address | Palo Alto, CA 94304-1611 |
Second Address | Palo Alto, CA 94305-5739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2011 |
Last Update Date | 27/08/2012 |