Provider Demographics
NPI:1043404130
Name:PANG, EUGENIA S H (OTRL)
Entity Type:Individual
Prefix:MS
First Name:EUGENIA
Middle Name:S H
Last Name:PANG
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93024
Mailing Address - Country:US
Mailing Address - Phone:805-646-7781
Mailing Address - Fax:805-646-7781
Practice Address - Street 1:3291 LOMA VISTA RD
Practice Address - Street 2:VENTURA COUNTY MEDICAL CENTER
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-648-9980
Practice Address - Fax:805-648-9870
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2024225X00000X
AZ0523225X00000X
HI0393225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist