Provider Demographics
NPI:1659770659
Name:ZOTOS, GEORGE PHILLIP (PHARM-D)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:PHILLIP
Last Name:ZOTOS
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2426
Mailing Address - Country:US
Mailing Address - Phone:207-475-5665
Mailing Address - Fax:
Practice Address - Street 1:2020 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1314
Practice Address - Country:US
Practice Address - Phone:415-436-9032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist