Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | C142141 | CA |
N | 2080P0201X | Pediatric Allergist | MD.201027 | LA |
NPI | 1588850309 |
---|---|
Provider Name | Dr. Victoria Ritsa Dimitriades |
First Address | Sacramento, CA 95817-2208 |
Second Address | Sacramento, CA 95817-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2007 |
Last Update Date | 28/05/2020 |