MEDICARE: DR. KATERINA A CHRISTOPOULOS MD

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
1	207R00000X	Internal Medicine Physician	226272	MA
2	207RI0200X	Infectious Disease Physician	239812	NY
3	207RI0200X	Infectious Disease Physician	105495	CA

General Provider Information

NPI Number	:	1902887847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATERINA A CHRISTOPOULOS MD

Provider Business Mailing Address
First Line	:	995 POTRERO AVE
Second Line	:	WARD 84
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2859
Country	:	US
Telephone Number	:	415-476-4082
Fax Number	:	415-476-6953

Provider Business Practice Location Address
First Line	:	995 POTRERO AVE
Second Line	:	WARD 84
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2859
Country	:	US
Telephone Number	:	415-476-4082
Fax Number	:	415-476-6953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	01/09/2012

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