Provider Demographics
NPI:1295026417
Name:PAN, GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:PAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:25775 MCBEAN PKWY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3708
Mailing Address - Country:US
Mailing Address - Phone:661-255-8252
Mailing Address - Fax:661-259-0552
Practice Address - Street 1:25775 MCBEAN PKWY
Practice Address - Street 2:SUITE 214
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3708
Practice Address - Country:US
Practice Address - Phone:661-255-8252
Practice Address - Fax:661-259-0552
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA132921207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine