Provider Demographics
NPI:1336324920
Name:PANOSYAN, EDUARD HAYRAPET (MD)
Entity Type:Individual
Prefix:
First Name:EDUARD
Middle Name:HAYRAPET
Last Name:PANOSYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W. CARSON STREET,
Mailing Address - Street 2:BLDG N25, MAIL BOX 468. HARBOR-UCLA MEDCNTR, PEDIATRICS
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90509
Mailing Address - Country:US
Mailing Address - Phone:310-222-4171
Mailing Address - Fax:310-320-2271
Practice Address - Street 1:1000 W. CARSON STREET,
Practice Address - Street 2:BLDG N25, MAIL BOX 468. HARBOR-UCLA MEDCNTR, PEDIATRICS
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90509
Practice Address - Country:US
Practice Address - Phone:310-222-4171
Practice Address - Fax:310-320-2271
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101164208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics