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NPI Code Detail

MEDICARE: DR. DIMITRIOS MICHAEL PALILIS AUD

MEDICARE: DR. DIMITRIOS MICHAEL PALILIS AUD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologistAU2496CA

General Provider Information

NPI Number : 1790005999
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIMITRIOS MICHAEL PALILIS AUD
Provider Business Mailing Address
First Line : 744 EMPIRE ST # 210
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-5562
Country : US
Telephone Number : 707-759-4419
Fax Number : 510-483-3685
Provider Business Practice Location Address
First Line : 744 EMPIRE ST # 210
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-5562
Country : US
Telephone Number : 707-759-4419
Fax Number : 510-483-3685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2010
Last Update Date : 01/06/2021

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