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General NPI Number Information
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NPI Number | 1013114719
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Entity Type | Individual
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Provider Name | VASILIKI TATSIS MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 2262 N STATE COLLEGE BLVD
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City | FULLERTON
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State | CA
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Zip | 92831-1361
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Country | US
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Telephone | 714-990-2900
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Fax | 714-990-3133
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Provider Business Mailing Address
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Address Line | 4715 BLUE MOUNTAIN DR
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City | YORBA LINDA
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State | CA
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Zip | 92887-2606
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Country | US
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Telephone | 714-777-4911
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A100473
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License Number State | CA
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