Individual
STEPHEN LINDSAY VILTRAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
3300 RENNER DR., FORTUNA, CA 95540
(707) 725-3361
Mailing address
P. O. BOX 6640, EUREKA, CA 95502
(707) 445-5431
(707) 445-3710
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G72357
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G723570
—
CA
Enumeration date
10/05/2006
Last updated
07/08/2007
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