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General NPI Number Information
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NPI Number | 1790005999
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Entity Type | Individual
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Provider Name | DIMITRIOS MICHAEL PALILIS AUD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 744 EMPIRE ST # 210
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City | FAIRFIELD
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State | CA
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Zip | 94533-5562
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Country | US
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Telephone | 707-759-4419
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Fax | 510-483-3685
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Provider Business Mailing Address
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Address Line | 744 EMPIRE ST # 210
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City | FAIRFIELD
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State | CA
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Zip | 94533-5562
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Country | US
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Telephone | 707-759-4419
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Fax | 510-483-3685
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AU2496
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License Number State | CA
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