Healthcare Provider Details

I. General information

NPI: 1669514972
Provider Name (Legal Business Name): DENNIS B KOTTLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31822 VILLAGE CENTER RD SUITE 203
WESTLAKE VILLAGE CA
91361-4330
US

IV. Provider business mailing address

31822 VILLAGE CENTER RD SUITE 203
WESTLAKE VILLAGE CA
91361-4330
US

V. Phone/Fax

Practice location:
  • Phone: 818-991-8376
  • Fax: 818-879-1187
Mailing address:
  • Phone: 818-991-8376
  • Fax: 818-879-1187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG38830
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: