Doctor Name: | ERNEST PETER KOTSOS |
NPI Number: | 1013054964 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 7566 |
Business Practice Address: | 10172 Pinecastle St San Diego, CA - 921312291 |
Business Phone Number: | 8586894981 |
Business Fax Number: | |
Mailing Address: | 10172 Pinecastle St, SAN DIEGO |
State: | CA |
Postal Code: | 921312291 |
Phone Number: | 8586894981 |
Fax Number: | |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 7566 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |