MEDICARE: DR. DANIEL F IACOPI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	G30887	CA

General Provider Information

NPI Number	:	1659397727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL F IACOPI MD

Provider Business Mailing Address
First Line	:	16055 VENTURA BLVD STE 545
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2609
Country	:	US
Telephone Number	:	818-990-6616
Fax Number	:	818-990-6773

Provider Business Practice Location Address
First Line	:	16055 VENTURA BLVD STE 545
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2609
Country	:	US
Telephone Number	:	818-990-6616
Fax Number	:	818-990-6773

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	10/04/2011

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