Individual
DR. PETER JOHN PANAGOTACOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 UNION ST, SUITE #520, SAN FRANCISCO, CA 94123-4114
(415) 922-3344
(415) 921-7759
Mailing address
2001 UNION ST, SUITE #520, SAN FRANCISCO, CA 94123-4114
(415) 922-3344
(415) 921-7759
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
C36061
CA
207NS0135X
Procedural Dermatology Physician
C36061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ53573Z
ANTHEM
CA
Enumeration date
04/06/2007
Last updated
08/13/2018
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