Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | G57889 | CA |
NPI | 1083621957 |
---|---|
Provider Name | Dr. Gus George Halamandaris |
First Address | Salinas, CA 93901-3901 |
Second Address | Salinas, CA 93901-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
94170316793901A005 | TRICARE (01) | |
E54093 | (02) | |
ZZZ70373Z | (05) | CA |