Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A100473 | CA |
NPI | 1013114719 |
---|---|
Provider Name | Vasiliki Tatsis |
First Address | Yorba Linda, CA 92887-2606 |
Second Address | Fullerton, CA 92831-1361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 19/01/2010 |