Provider Demographics
NPI:1770608085
Name:SOTOS, J G (MD)
Entity type:Individual
Prefix:DR
First Name:J
Middle Name:G
Last Name:SOTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1788 OAK CREEK DR APT 415
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2132
Mailing Address - Country:US
Mailing Address - Phone:501-694-9807
Mailing Address - Fax:
Practice Address - Street 1:1788 OAK CREEK DR APT 415
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2132
Practice Address - Country:US
Practice Address - Phone:501-694-9807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033318207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease