Provider Demographics
NPI:1598058448
Name:PANOS, AGLAIA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AGLAIA
Middle Name:
Last Name:PANOS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:AGLAIA
Other - Middle Name:
Other - Last Name:PANOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:13240 CLAIREPOINTE WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-3507
Mailing Address - Country:US
Mailing Address - Phone:510-907-0717
Mailing Address - Fax:510-531-8633
Practice Address - Street 1:13240 CLAIREPOINTE WAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-3507
Practice Address - Country:US
Practice Address - Phone:510-907-0717
Practice Address - Fax:510-531-8670
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist