Provider Demographics
NPI:1275866428
Name:IOANNOU, IOANNI (MA)
Entity Type:Individual
Prefix:MR
First Name:IOANNI
Middle Name:
Last Name:IOANNOU
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 W 2ND ST APT 56-303
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-6130
Mailing Address - Country:US
Mailing Address - Phone:720-519-9209
Mailing Address - Fax:
Practice Address - Street 1:8300 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-3422
Practice Address - Country:US
Practice Address - Phone:720-519-9209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program