Individual
PETER ANTHONY FOTINAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 W LA VETA AVE STE 750, ORANGE, CA 92868-4312
(714) 639-9401
Mailing address
1010 W LA VETA AVE STE 750, ORANGE, CA 92868-4312
(714) 639-9401
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
G48227
CA
2084N0400X
Neurology Physician
G48227
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130025839
RAIL ROAD MEDICARE - PROVIDER PTAN
CA
01
—
1912919804
TYPE 2 NPI
CA
01
—
1912919804
NPI - TYPE 2
—
01
—
CG5665
RAIL ROAD MEDICARE - GROUP PTAN
CA
Enumeration date
03/14/2006
Last updated
07/21/2022
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