Individual
DR. DAPHNE I PANAGOTACOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
32144 AGOURA RD, SUITE 106, WESTLAKE VILLAGE, CA 91361-4031
(805) 379-3376
(805) 379-3267
Mailing address
32144 AGOURA RD, SUITE 106, WESTLAKE VILLAGE, CA 91361-4031
(805) 379-3376
(805) 379-3267
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G66971
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G66971
CA
207NP0225X
Pediatric Dermatology Physician
G66971
CA
Other
Enumeration date
09/09/2006
Last updated
08/02/2012
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