Provider Demographics
NPI:1710156583
Name:VOULGARIS, GEORGIOS (PT)
Entity Type:Individual
Prefix:
First Name:GEORGIOS
Middle Name:
Last Name:VOULGARIS
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 1:8311 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3928
Mailing Address - Country:US
Mailing Address - Phone:562-923-4911
Mailing Address - Fax:
Practice Address - Street 1:8311 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3928
Practice Address - Country:US
Practice Address - Phone:562-923-4900
Practice Address - Fax:562-904-2060
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PT229170Medicaid