Healthcare Provider Details

I. General information

NPI: 1255468187
Provider Name (Legal Business Name): HARRY PETROPOULOS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HARALAMBOS PETROPOULOS M.D

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7817 OAKPORT ST STE 140
OAKLAND CA
94621-2036
US

IV. Provider business mailing address

22139 CASTILLE LN APT 64
HAYWARD CA
94541-2867
US

V. Phone/Fax

Practice location:
  • Phone: 510-638-0701
  • Fax:
Mailing address:
  • Phone: 510-583-1002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA-30881
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: