Provider Demographics
NPI:1477872695
Name:KALOFONOS, IPPOLYTOS ANDREAS (MD, PHD, MPH, MS)
Entity Type:Individual
Prefix:DR
First Name:IPPOLYTOS
Middle Name:ANDREAS
Last Name:KALOFONOS
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Gender:M
Credentials:MD, PHD, MPH, MS
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Mailing Address - Street 1:10940 WILSHIRE BLVD
Mailing Address - Street 2:710
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3915
Mailing Address - Country:US
Mailing Address - Phone:510-219-3615
Mailing Address - Fax:310-794-3288
Practice Address - Street 1:10940 WILSHIRE BLVD
Practice Address - Street 2:710
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3915
Practice Address - Country:US
Practice Address - Phone:510-219-3615
Practice Address - Fax:310-794-3288
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2014-10-13
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Provider Licenses
StateLicense IDTaxonomies
CAA1298892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry