Provider Demographics
NPI:1972734119
Name:ROYTER, VLADIMIR (MD)
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:ROYTER
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 1:125 MALL DR STE 209B
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5794
Mailing Address - Country:US
Mailing Address - Phone:559-584-9000
Mailing Address - Fax:559-589-9015
Practice Address - Street 1:125 MALL DR STE 209B
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5794
Practice Address - Country:US
Practice Address - Phone:559-584-9000
Practice Address - Fax:559-589-9015
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 1090622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology