Provider Demographics
NPI:1255468187
Name:PETROPOULOS, HARRY (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:PETROPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:HARALAMBOS
Other - Middle Name:
Other - Last Name:PETROPOULOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:22139 CASTILLE LN APT 64
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2867
Mailing Address - Country:US
Mailing Address - Phone:510-583-1002
Mailing Address - Fax:
Practice Address - Street 1:7817 OAKPORT ST STE 140
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2036
Practice Address - Country:US
Practice Address - Phone:510-638-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-30881207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine