Louis Poulos
Periodontist
2581 Samaritan Dr Suite 310
San Jose
, California 95124-4113
Louis Poulos
Periodontist
2581 Samaritan Dr Suite 310
San Jose
, California 95124-4113
(409) 356-9735
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Louis Poulos
- 2581 Samaritan Dr Suite 310
- San Jose, CA
- Zip : 95124-4113
- Fax : (409) 356-9735
- Phone : (408) 356-9366
Second Address
- Louis Poulos
- 2581 Samaritan Dr Suite 310
- San Jose, CA
- Zip : 95124-4113
- Fax : (409) 356-9735
- Phone : (408) 356-9366
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 21283 | CA |
National Provider Identifier
| NPI | 1114139292 |
|---|---|
| Provider Name | Louis Poulos |
| First Address | San Jose, CA 95124-4113 |
| Second Address | San Jose, CA 95124-4113 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.