Healthcare Provider Details

I. General information

NPI: 1427709302
Provider Name (Legal Business Name): GEORGIOS VLAHOYLIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 S EUCLID AVE
PASADENA CA
91101-3125
US

IV. Provider business mailing address

336 S EUCLID AVE
PASADENA CA
91101-3125
US

V. Phone/Fax

Practice location:
  • Phone: 213-640-9003
  • Fax:
Mailing address:
  • Phone: 213-640-9003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number19223
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: