Provider Demographics
NPI:1487997102
Name:LIVOTI, LOUIS G (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:G
Last Name:LIVOTI
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 1:140 GARNER CT
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-4426
Mailing Address - Country:US
Mailing Address - Phone:415-892-1043
Mailing Address - Fax:
Practice Address - Street 1:140 GARNER CT
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-4426
Practice Address - Country:US
Practice Address - Phone:415-892-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG21185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine