Healthcare Provider Details

I. General information

NPI: 1659770659
Provider Name (Legal Business Name): GEORGE PHILLIP ZOTOS PHARM-D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 MARKET ST
SAN FRANCISCO CA
94114-1314
US

IV. Provider business mailing address

1611 BAKER ST
SAN FRANCISCO CA
94115-2426
US

V. Phone/Fax

Practice location:
  • Phone: 415-436-9032
  • Fax:
Mailing address:
  • Phone: 207-475-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: