Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD461357 | PA |
N | 111NI0900X | Internist | MD461357 | PA |
Y | 207RR0500X | Rheumatology | A161173 | CA |
NPI | 1083034896 |
---|---|
Provider Name | Vladislav Tsaltskan |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103-9000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2014 |
Last Update Date | 20/08/2021 |