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General NPI Number Information
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NPI Number | 1164242095
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Entity Type | Organization
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Legal Business Name | ETHOS MEDICAL ASSOCIATES P.C.
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 3887 PELL PL UNIT 433
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City | SAN DIEGO
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State | CA
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Zip | 92130-4154
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Country | US
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Telephone | 215-872-1024
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Fax |
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Provider Business Mailing Address
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Address Line | 3887 PELL PL UNIT 433
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City | SAN DIEGO
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State | CA
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Zip | 92130-4154
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IGOR SISTER
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Credential |
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Telephone | 215-872-1024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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