Organization
DAPHNE I PANAGOTACOS MD
Active
Other names
DAPHNE I PANAGOTACOS MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAPHNE IRMGARD PANAGOTACOS MD (OWNER)
(805) 379-3376
Entity
Organization
Contact information
Practice address
1250 LA VENTA DR, SUITE 105, WESTLAKE VILLAGE, CA 91361-3758
(805) 379-3376
(805) 379-3267
Mailing address
1250 LA VENTA DR, SUITE 105, WESTLAKE VILLAGE, CA 91361-3758
(805) 379-3376
(805) 379-3267
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G66971
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811091069
INDIVIDUAL NPI NUMBER
CA
Enumeration date
10/10/2006
Last updated
08/22/2020
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