Provider Demographics
NPI:1124076435
Name:LALIOTIS, ARISTOTELIS THEODORE (MD)
Entity type:Individual
Prefix:
First Name:ARISTOTELIS
Middle Name:THEODORE
Last Name:LALIOTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 VIA DE LA VALLE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-1992
Mailing Address - Country:US
Mailing Address - Phone:858-499-2600
Mailing Address - Fax:858-309-3269
Practice Address - Street 1:2600 VIA DE LA VALLE
Practice Address - Street 2:SUITE 200
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-1992
Practice Address - Country:US
Practice Address - Phone:858-499-2600
Practice Address - Fax:858-309-3269
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA054580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G50340Medicare UPIN
A54580Medicare ID - Type Unspecified