Provider Demographics
NPI:1174833263
Name:PANLILIO, JAMES P (PA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:PANLILIO
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 4419
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91365-4419
Mailing Address - Country:US
Mailing Address - Phone:818-340-9988
Mailing Address - Fax:818-587-2493
Practice Address - Street 1:12401 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1006
Practice Address - Country:US
Practice Address - Phone:562-698-0811
Practice Address - Fax:818-587-2493
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2021-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA21179363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant