Provider Demographics
NPI:1285073577
Name:JOHN G. APOSTOLIDES, MD, INC.
Entity type:Organization
Organization Name:JOHN G. APOSTOLIDES, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:APOSTOLIDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-871-9448
Mailing Address - Street 1:1322 SCOTT ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2747
Mailing Address - Country:US
Mailing Address - Phone:619-222-3339
Mailing Address - Fax:619-223-3339
Practice Address - Street 1:1322 SCOTT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2747
Practice Address - Country:US
Practice Address - Phone:619-222-3339
Practice Address - Fax:619-223-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111220208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty