Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G81975 | CA |
NPI | 1275702797 |
---|---|
Provider Name | Dr. Frank J Papatheofanis |
First Address | San Diego, CA 92103-8758 |
Second Address | San Diego, CA 92103-8758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2008 |
Last Update Date | 28/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G819750 | (05) | CA |
G20696 | (02) | CA |