Individual
FOTINI TANIA MITSINIKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4650 W SUNSET BLVD, MS#78, LOS ANGELES, CA 90027-6062
(323) 361-2181
Mailing address
4650 W SUNSET BLVD, MS#78, LOS ANGELES, CA 90027-6062
(323) 361-2181
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A123951
CA
Other
Enumeration date
07/14/2013
Last updated
07/11/2014
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