Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 56008 | CA |
NPI | 1033385190 |
---|---|
Provider Name | Dr. Anastasios Sotirios Photopoulos |
First Address | Santa Clara, CA 95050-4555 |
Second Address | Santa Clara, CA 95050-4555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 15/02/2017 |