Provider Demographics
NPI:1932934825
Name:FOTROS PSYCHIATRIC GROUP PC
Entity type:Organization
Organization Name:FOTROS PSYCHIATRIC GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARYANDOKHT
Authorized Official - Middle Name:
Authorized Official - Last Name:FOTROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-699-4888
Mailing Address - Street 1:4216 S MOONEY BLVD PMB 309
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277
Mailing Address - Country:US
Mailing Address - Phone:559-509-0846
Mailing Address - Fax:
Practice Address - Street 1:1100 S AKERS ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8311
Practice Address - Country:US
Practice Address - Phone:559-509-0846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty