Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 36605 | CA |
NPI | 1023179884 |
---|---|
Provider Name | Evangelos Rossopoulos |
First Address | Whittier, CA 90602-3102 |
Second Address | Whittier, CA 90602-3102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |