Dr. Pericles Ioannides, M.D.
in Sonora, CA. Individual provider (NPI-1).
NPI number1386007367
StatusActive
Last updated in NPPESJun 3, 2022
Details
- NPI
- 1386007367
- Entity type
- Individual (NPI-1)
- Name
- Dr. Pericles Ioannides
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2016
- Certification date
- Jun 3, 2022
- Last updated
- Jun 3, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | A154867 | CA | Yes |
Practice location
900 Mono WaySonora, CA 95370-5229
Phone 209-536-6915
Mailing address
900 Mono WaySonora, CA 95370-5229
Phone 209-536-6915
Other practice locations
2407 W Vine St
Lodi, CA 95242-3730
Lodi, CA 95242-3730
Phone 209-333-3056
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