Basic Information
Provider Information
NPI: 1154319754
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALATZIS
FirstName: CHRISTOS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2757
Address2:  
City: ORANGE
State: CA
PostalCode: 928590757
CountryCode: US
TelephoneNumber: 7149732650
FaxNumber: 7149732655
Practice Location
Address1: 2601 E CHAPMAN AVE
Address2:  
City: ORANGE
State: CA
PostalCode: 928693206
CountryCode: US
TelephoneNumber: 7146330011
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/10/2005
LastUpdateDate: 06/26/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA40074CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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