Provider Demographics
NPI:1659397727
Name:IACOPI, DANIEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:IACOPI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16055 VENTURA BLVD STE 545
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2609
Mailing Address - Country:US
Mailing Address - Phone:818-990-6616
Mailing Address - Fax:818-990-6773
Practice Address - Street 1:16055 VENTURA BLVD STE 545
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2609
Practice Address - Country:US
Practice Address - Phone:818-990-6616
Practice Address - Fax:818-990-6773
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG308872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A91315Medicare UPIN
CAG30887Medicare ID - Type Unspecified