Provider Demographics
NPI:1497033344
Name:RAFTOPOULOS, EVANTHIS (PT)
Entity Type:Individual
Prefix:MR
First Name:EVANTHIS
Middle Name:
Last Name:RAFTOPOULOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 GUERRERO ST APT 203
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1051
Mailing Address - Country:US
Mailing Address - Phone:415-685-6673
Mailing Address - Fax:
Practice Address - Street 1:601 VAN NESS AVE STE 2008
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6310
Practice Address - Country:US
Practice Address - Phone:415-685-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist