Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 20A11260 | CA |
NPI | 1073829685 |
---|---|
Provider Name | Dr. Christina Pantazopoulos |
First Address | Riverside, CA 92501-4020 |
Second Address | Riverside, CA 92501-4020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2010 |
Last Update Date | 29/12/2020 |