Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A54923 | CA |
N | 207PE0004X | Emergency Medical Services | A54923 | CA |
NPI | 1114900255 |
---|---|
Provider Name | Dr. Georgia Sotiropoulos |
First Address | Emeryville, CA 94608-1844 |
Second Address | Los Angeles, CA 90048-1865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 21/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A869610 | (05) | CA |
G79543 | (02) | CA |