Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A45948 | CA |
NPI | 1023080157 |
---|---|
Provider Name | George Triadafilopoulos |
First Address | Sunnyvale, CA 94085-4513 |
Second Address | Mountain View, CA 94040-4122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 27/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B77205 | (02) | CA |