Provider Demographics
NPI:1659669232
Name:PSALTIS, ALKIVIADIS JAMES (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:ALKIVIADIS
Middle Name:JAMES
Last Name:PSALTIS
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:DR
Other - First Name:ALKIS
Other - Middle Name:JAMES
Other - Last Name:PSALTIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:801 WELCH RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1611
Mailing Address - Country:US
Mailing Address - Phone:843-906-6028
Mailing Address - Fax:
Practice Address - Street 1:801 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94305-5739
Practice Address - Country:US
Practice Address - Phone:843-906-6028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33972207Y00000X
CAF5720207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology