Stathacopoulos, Rena A.

Stathacopoulos, Rena A. is an individual health care provider with primary practice located at 234 Heather Ct Suite 102, Templeton CA 93465-8765. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Stathacopoulos, Rena A. can be contacted via phone (805) 434-5970.

Contact Information

Primary practice address
234 Heather Ct Suite 102 Templeton CA 93465-8765
Fax: (805) 434-5973
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G65410 California

Profile Details

NPI number 1881609238
LBN Legal business name Stathacopoulos, Rena A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Jan 15th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881609238 NPPES
California MEDICAID 00G654100

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