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General NPI Number Information
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NPI Number | 1538288311
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Entity Type | Individual
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Provider Name | GEORGE PISIMISIS MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 2720 N HARBOR BLVD STE 140
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City | FULLERTON
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State | CA
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Zip | 92835-2625
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Country | US
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Telephone | 657-566-8800
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Fax | 657-566-8810
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Provider Business Mailing Address
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Address Line | 71780 SAN JACINTO DR BLDG I
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-5516
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Country | US
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Telephone | 760-568-3461
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Fax | 760-423-6273
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | C175395
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License Number State | CA
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