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NPI Code Detail

MEDICARE: DR. NIKOLAOS M STEFANIDIS PH.D

MEDICARE: DR. NIKOLAOS M STEFANIDIS PH.D
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
1101YM0800XMental Health CounselorPSY 14035CA

General Provider Information

NPI Number : 1982745501
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NIKOLAOS M STEFANIDIS PH.D
Provider Business Mailing Address
First Line : 5000 W SUNSET BLVD
Second Line : 4TH FLOOR
City : LOS ANGELES
State : CA
Zip : 90027-5861
Country : US
Telephone Number : 323-669-4140
Fax Number :
Provider Business Practice Location Address
First Line : 6043 HOLLYWOOD BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-5411
Country : US
Telephone Number : 323-337-1729
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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